Adopt-A-Spot Report Form

Share your impact! Complete this form after your litter cleanup. Include photos and we'll give you a shout out on social media. This information is shared with Keep America Beautiful, Keep Texas Beautiful, and City of Denton leadership and helps us keep supplies in stock year-round.

Name of Adopter (Group Name)

Primary Contact Name

Primary Contact Email

Primary Contact Phone Number

Phone

Date of your Litter Cleanup

mm/dd/yyyy

Cleanup Location

Total number of volunteers who helped with the cleanup

Length of Cleanup (hours)

Please enter in quarter hour increments, i.e. 1 hour 15 minutes = 1.25

How littered was the location prior to the cleanup:

Total bags of trash cleaned up

Total bags of recycling cleaned up

Please select the items you picked up during the cleanup.

Hard/solid plastic (e.g. bottles, bottle caps, straws, cigarette butts, cups, personal care product, etc.)

Styrofoam (e.g. styrofoam cups, to-go boxes, egg cartons, insulation pieces)

Plastic Film (e.g. chip bags, clear wrappers, candy wrappers, grocery bags)

Metal (e.g. aluminum cans and foil, tin cans, metal bottle caps)

Glass

Rubber (e.g. tires, flip flops, shoe soles)

PPE (e.g. masks, vinyl gloves)

Paper/Lumber - any MAN MADE products made from trees/wood (e.g. cardboard)

Clothing/Fabric (e.g. rope, towels, shoe tops)

Other cleanup notes and items found:

Program Evaluation

Evaluate the following statements relating to your cleanup experience. This helps us to improve our program for future cleanups!

Our Adopt-A-Spot location is a good fit for the group.

Strongly Disagree

Disagree

Agree

Strongly Agree

We received a good amount of supplies to complete our cleanup.

Strongly Disagree

Disagree

Agree

Strongly Agree

We received prompt communication in response to questions and concerns regarding our Adopt-A-Spot.

Strongly Disagree

Disagree

Agree

Strongly Agree

We were able to see the positive impact they had on the area.

Strongly Disagree

Disagree

Agree

Strongly Agree

We would recommend volunteering for the Adopt-A-Spot program to our network.

Strongly Disagree

Disagree

Agree

Strongly Agree

Additional Comments:

We appreciate you!

We'd love to tag you on social media in an appreciation post! Please paste the links to the account you'd like tagged on Facebook, Instagram, and/or Twitter pages below.

Facebook

Instagram

Twitter

Please share your cleanup photos!

Drop your files here

Send me a copy of my responses

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