Adopt-A-Highway Schedule Cleanup/Request Supplies Form

Adopt-a-Highway
Schedule A Clean Up/Request Supplies Form
 
Please fill in the information below and click 'Submit'.
 
Forms can also be faxed to (302) 739-2092, Attn: Tina Shockley; or mailed to:
Delaware Department of Transportation
Adopt-A-Highway Program
P.O. Box 778, Dover, DE 19903-0778
 
This form must be completed at least one week prior to picking up your supplies at your local district office - Thanks.
Participant Information  

(  )   - 

I am a new contact person for this group, my mailing address is:

I am an alternate contact person for the group.
Location Information  
County*
New Castle Kent Sussex
Cleanup Schedule  
:  
Supplies Requested  
:

Trash Disposal  
:
I will dispose of trash myself.
I need DelDOT to pick up the trash at

(We prefer under your AAH sign. Please note that a completed activity report should be submitted to ensure DelDOT picks up the trash.)

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