Volunteer Feedback Template Question Title * 1. What cleanup event are you reporting for? Great American Cleanup - April & May (Spring) Coastal Cleanup - Sept (Fall) Question Title * 2. Did you provide any advance notice of your plans to clean your area to your Caltrans representative? Yes No Question Title * 3. Contact Information Contact Name Group Name Address Address 2 City/Town State/Province -- select state -- AL AlabamaAK AlaskaAS American SamoaAZ ArizonaAR ArkansasCA CaliforniaCO ColoradoCT ConnecticutDE DelawareDC District of ColumbiaFM Federated States of MicronesiaFL FloridaGA GeorgiaGU GuamHI HawaiiID IdahoIL IllinoisIN IndianaIA IowaKS KansasKY KentuckyLA LouisianaME MaineMH Marshall IslandsMD MarylandMA MassachusettsMI MichiganMN MinnesotaMS MississippiMO MissouriMT MontanaNE NebraskaNV NevadaNH New HampshireNJ New JerseyNM New MexicoNY New YorkNC North CarolinaND North DakotaMP Northern Mariana IslandsOH OhioOK OklahomaOR OregonPW PalauPA PennsylvaniaPR Puerto RicoRI Rhode IslandSC South CarolinaSD South DakotaTN TennesseeTX TexasUT UtahVT VermontVI Virgin IslandsVA VirginiaWA WashingtonWV West VirginiaWI WisconsinWY Wyoming ZIP/Postal Code Email Address Phone Number Question Title * 4. How many in your group participated in this event? Number of people Hours each person worked Question Title * 5. What is the average age in your group? 18-25 26-35 36-45 46-59 60+ Question Title * 6. If you know this info great! County Route Postmile Question Title * 7. This information is critical to us! Trash Bags Collected Bags of Recyclables Collected Vegetation Controlled (acres) Number of Tree Plantings Graffiti Removed (sq ft) Question Title * 8. Have you ever kept recyclables found? (We encourage recycling!) Yes No Question Title * 9. Did you keep any recyclables for this event? Yes No Question Title * 10. How likely is it that you would recommend Adopt-A-Highway to a friend or colleague? Not at all likely Extremely likely 0 1 2 3 4 5 6 7 8 9 10 0 1 2 3 4 5 6 7 8 9 10 Question Title * 11. Please tell us your comments Most unusual item found Ideas for improvement Done