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Keep Mansfield Beautiful Commission (KMBC) Adopt-A-Street Cleanup Report

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This form has been modified since it was saved. Please review all fields before submitting.

After every cleanup event, please fill out the following form so we can update our data and give your group credit for the cleanup.
Organization Name
Contact Name*
Email
Phone*
Date of Cleanup/Project
Date of Cleanup/Project
Cleanup/Project Location
City
State
Zip Code
Number of Volunteers
Number of Hours to Complete Cleanup/Project
Number of Bags of Trash Collected
Cleanup photo
Description of Project
Adopt-a-street, trash cleanup, community service project, other, etc.
Types of litter picked up
1. Aluminum cans
2. Balloons
3. Cigarettes
4. Glass bottles
5. Large or bulky items
6. Masks / Gloves / PPE
7. Paper
8. Plastic bags
9. Plastic bottles
10. Plastic utensils / straws
11. Styrofoam
12. Tires
13. To-Go cups / packaging