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Adopt-A-Program Supply Request
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Welcome to the Adopt-A-Program Supply Request form! Please fill out the following form to request cleanup supplies from Keep Allen Beautiful. These supplies are available for adopters and community members interested in doing one time cleanups.
Organization Name:
*
Your Name
*
E-mail
*
Phone Number
*
Date of Cleanup
*
Supplies may be picked up at the Utility Billing window at City Hall. You will receive a confirmation e-mail in two business days.
Supply Pickup Date: (Please allow 1-2 weeks notice for all supply requests)
*
Approximate Number of Volunteers
*
Cleanup Type
*
Adopt-A-Highway
Adopt-A-Spot
Adopt-A-Waterway
One Time Cleanup (Non-Adopter)
Cleanup Location (List assigned area number whenever possible or intersection)
*
Pickers? (Pickers are limited to 1 per 5 volunteers)
*
Yes
No
Safety Vests (Request safety vests if you're group is near major highways, highly dense forest, or has children).
*
Yes
No
Yellow Litter Bags (Use smaller bags for individual collections then combine them into larger yellow bags. Leave them by the roadway or adoption sign for collection.)
*
Yes
No
Latex Gloves (1 glove per volunteer. It is supposed to be worn on the hand collecting litter. This limits the amount of waste we create during the cleanups).
*
Yes
No
Leather Gloves (These are for heavy duty cleanups that require bulky items. 1 or 2 pairs are usually offered per group).
*
Yes
No
Thank you for filling out the form. It will be sent to the Adopt-A-Program coordinator, Josué Diaz. He can be reached at 214-509-4555 or jdiaz@cityofallen.org. Please allow 3-5 business days for a confirmation.
* indicates required fields.
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