Request edit access
Adopt-a-Block Sign-Up
The NEC's Adopt-a-Block Program allows individuals, businesses, faith based groups, non-profit organizations, schools, and other entities to take ownership of and participate in enhancing the appearance of our wonderful community and preventing the pollution of our vital watershed. All you need to do is fill out the form below and a staff person will contact you within a few days to discuss the next steps required to complete the Adopt-a-Block process. More information on guidelines and benefits here: http://yournec.org/adoptablock
Primary Contact Name
Your answer
Phone Number
Your answer
Address
Your answer
Email
Your answer
Group/Entity Name
If not participating as an individual
Your answer
Group/Entity Type
ex: nonprofit, school group, business
Your answer
Number of Volunteers
Your answer
Preferred Method of Communication
Required
Are you an NEC Member?
Are you over 55?
If so, you will also be required to fill out the liability form for RSVP.
Blocks Interested in Adopting
Can be a trail, storefront, block, city square, or other Arcata parcel. Describe as needed.
Your answer
How often do you plan to clean your block?
Would you like to rent equipment?
Captionless Image
Required
How did you hear about the Adopt-a-Block Program?
Your answer
Thank you for your interest in keeping Arcata and our watershed clean for all species!
The NEC will send monthly reminders to return your data. Liability forms are required for all participants and can be found at http://yournec.org/marinedebris/cleanup-forms or at our office. If you are over 55, you will be asked to sign the Retired Senior Volunteer Program's insurance liability form. Please return form by mail to: NEC PO Box 4259 Arcata, CA 95518 or drop off at 415 I St. Arcata, CA 95521.
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Additional Terms