No Trash November Notification/Supplies Request

Spokesperson Name *

First Name

Last Name

Spokesperson Phone *

(###)

###

####

Is your group a part of Adopt-A-Road? *

Yes

No

Cleanup Date *

MM

DD

YYYY

Supplies Requested *

Litter Pickers

Safety Vests

Gloves

Trash Bags

Road Safety Signs

None

Do you agree to return the supplies the day after the cleanup? *

Supplies checked out over the weekend will be returned on the following Monday.

Yes

Do you agree to report your cleanup results via the online form within 48 hours of your cleanup? *

Yes

How will you dispose of the trash? *

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)

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