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2. Name of Group or Organization:
3. Contact Person:
5. Mailing Address
7. City
8. State
9. Zip Code
11. Phone Number:
12. Number of Individuals in the group:
14. E-Mail Address
16. Interested in adopting:

    1. Park
    2. Street

    1. Segment of Trail
18. Preferred areas to adopt:
20. 1.
21. 2.
23. COMMITMENT:
    
    

    • Pick up litter on a regular and continuing basis, preferably monthly.
    • Submit the Adopt-a-Park/Street/Trail Clean Up Report Form each time area is cleaned. Report any safety hazards on this form.
    • Generally maintain the assigned area in a manner that improves the beauty and overall appearance of the Town
25. Form will be submitted to the program coordinator:
    Gene Kotlinski
    Town of Normal Parks and Recreation Department
    100 E. Phoenix Ave.
    Normal, IL 61761
    Phone: (309) 454-9724
27. 
    
Leave This Blank:


29. 1. Receive an email copy of this form.
30. Email address

    This field is not part of the form submission.

31. Submit

* indicates a required field