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Adopt A Mile Volunteer Application

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First Name
Last Name
Home Address
City
State
Zip
Phone Number
Email Address
Organization Name
Organization Email Address
Organization Address
City
State
Zip Code
Organization Phone Number
List the City Street that you wish to adopt
Do you agree to host a cleanup event every quarter and notify the Public Works Department when this is scheduled?
1. Yes
2. No
Do you understand the city has the authority to remove the road marker if the road has not been cleaned in six months?
1. Yes
2. No