Adopt-A-Road Cleanup Notification and Supplies Request

We will have a limited number of supplies available from Sept 24-29 for the East Knoxville Community Cleanup. If possible, please schedule your litter cleanup for outside of these dates. Thank you!

Please give at least one week notice for supplies and litter crew request.

For questions filling out this form, please contact adoptaroad@keepknoxvillebeautiful.org or call 865-521-6957.

Group Name

Adopted Road Name

Spokesperson Name

First Name

Last Name

Spokesperson Email Address

Spokesperson Phone Number

(###)

###

####

Tentative Date of Cleanup

YYYY

Number of Participants Expected

Support Needed

Trash Bags

Gloves

Safety Vest

Litter Grabbers/Pickers

Traffic Safety Road Signs

How will you dispose of the trash?

We will bring the bags to a Knox County Convenience Center or dispose of myself

Please have the Knox County Litter Crew or City of Knoxville Public Service come get the bags from the stretch of road we clean. (Group must verify when cleanup is completed)

How and when would you like to receive your supplies?

Groups can pick up their supplies at the KKB office or have them delivered. Please give two weeks notice for supplies delivery.

Additional Comments

Please specify any specific quantities for supplies if it differs from the number of participants