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Adopt-a-Block 2024-2025
Reporting Form
Name of Contact
Email Address
Student Organization (include acronym if applicable)
Block Location and #
Date of Clean Up (MM/DD/YYYY)
Number of volunteers present at clean-up
Total number of hours by all volunteers
(ex: 2 volunteers x 2 hours = 4 total hours)
Number of bags of trash collected
Number of bags of recycling collected
Rate the cleanliness of your block on a scale of 1-5 (1-no trash, 5-excessive trash)
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Upload a photo of your project.
Drop files or click here to upload
If you would like to be tagged on our social media, please provide your social media handles.
Any additional comments you would like for us to know
Thank you for participating in the Adopt-a-Block program!
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