Adopt-A-Spot Report Form
This form is intended for use by COA Adopt-a-Spot and Neighborhood Cleanup participants. Please complete the form to the best of you ability. Contact Keep Atlanta Beautiful Commission if you have any questions and/or need cleanup supplies. KABC@atlantaga.gov or 404-330-6240
Email address *
Is this organization certified Adopt-A-Spot Group *
You have submitted an Adopt-A-Spot Application and been approved.
First and Last Name or Organization *
Ex: Jim Brown
Your answer
Phone Number *
Your answer
Date of Cleanup or Beautification *
MM
/
DD
/
YYYY
Describe Area of Cleanup or Beautification *
Select all that apply
Location *
Ex: Trinity Ave SW or Address (55 Trinity Ave SW)
Your answer
From Street *
Ex: Central Ave SW
Your answer
To Street *
Ex: Pryor St SW
Your answer
Number of Volunteers: *
Your answer
Number of Volunteers Under 18
Your answer
Total time worked: *
Approximate Distance of Area Cleaned or Beautified: *
Number of trash bags collected: *
Ex: Number only - 1, 8, 30
Your answer
Please describe any beautification efforts you completed (ex. planting, pruning, mulching, etc)
Your answer
Do you need 3 or more bags picked up from the curb? Email kabc@atlantaga.gov with Address or Intersection, and number of bags. *
NOTE: Please dispose of 2 or fewer bags.
Number of tires collected:
Your answer
Please contact Keep Atlanta Beautiful Commission if you have any questions and/or need cleanup supplies.
KABC@atlantaga.gov or 404-330-6240
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