Request edit access
JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Highland Park Adopt-a-Drain Form
Sign in to Google
to save your progress.
Learn more
* Indicates required question
*
Your answer
Email Address
*
Your answer
Home Address
*
Your answer
Nearby intersection
*
Your answer
Phone Number
*
Your answer
Have you watched the short video on how to safely clean a storm drain?
Yes
No
Clear selection
Do you agree to clean your adopted drain(s) at least twice a month?
Yes
No
Clear selection
Check which of the following items you would like.
safety vest
gloves
rake
plastic garbage bags
SHP T-shirt
Other:
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. -
Terms of Service
-
Privacy Policy
Does this form look suspicious?
Report
Forms
Help and feedback
Contact form owner
Help Forms improve
Report