Adopt-a-Park/Street/Trail Clean Up Report Form

2. Organization:

3. Contact Person:

5. Phone:

6. Email:

8. Cleanup Date:

9. Location:

11. Please report all participants with their name and telephone number:

13. 1.

15. 2.

17. 3.

19. 4.

21. 5.

23. 6.

25. 7.

27. 8.

29. 9.

31. 10.

33. Did you experience any problems cleaning in this area?

35. Are there any concerns or suggestions you would like to share with Town staff?

37. Form will be submitted to the program coordinator:

    Gene Kotlinski <BR>Town of Normal Parks and Recreation Department<BR>100 E. Phoenix Ave.<BR>Normal, IL 61761 <BR>Phone (309) 454-9724

    Gene Kotlinski
    Town of Normal Parks and Recreation Department
    100 E. Phoenix Ave.
    Normal, IL 61761
    Phone (309) 454-9724

Leave This Blank:


38. 1. Receive email copy
39. Email address

    This field is not part of the form submission.

40. Submit

* indicates a required field