Complete a Clean Up Report Card

Adopt-a-Program Clean Up Report Card

Complete this report card after each clean up. This report card is documentation of your group's participation and compliance as an active, participating member of the City of Virginia Beach's Adopt-A-Programs. Thank you!

Submitting Form

The form could not be submitted. Please review the form and fix the errors before trying to submit again.

Thank you for submitting your report card.

Which Adopt-a-Program did you participate in? *

Name of adopting group *

Group number *

Name of location *

Date of clean up *

Number of people *

Number of hours *

Total hours (# of people x # of hours) *

Number of bags *

Number of pounds (approximate) *

Name of contact person *

Email address *

Phone number *

If new contact, please provide address

Additional comments

Submit

Reset

Contact Information

Outdoor & Environmental Programs

Direct: (757) 385-4461 | Email: outdoors@VBgov.com

Share
Email
Print
↑↓

Text Size