Adopt-A-Street Online Application

Today's Date *

Organization Name *

Address *

Street Address Address Line 2 City State ZIP Code

Can your organization commit to cleaning up the adopted street(s) at least four times per year? *

Yes
No

If you cannot commit to four times per year, how many times per year can you commit to?

Which best describes your organization? *

Business or business association
Church
Government agancy
Neighborhood group
Homeowner association
Non-profit
Scouts
Social Club
Other

If you selected other, be sure to explain your organization in the following question.

Please tell us about your organization and why you want to adopt a street. *

When was your organization formed? Do you participate in other volunteer projects? How many are in the organization? *

Group Name (as you would like it to appear on the sign) *

Please note that signs are standard in size and color. Adjustments or additions cannot be made after all agreements have been finalized. Logos, addresses, phone numbers or email addresses will not be accepted.

Your Name *

First Last

Title, if any

Email address *

Phone or cell phone number *

What street(s) would you like to adopt? *

1. Pick a major street near where you meet or live in order to make the time commitment of 4 cleanups per year. 2. The street length or collection of streets must be a minimum of one mile, or two miles round trip. 3. Tell us the name(s) of the street(s) and the beginning and ending intersections, i.e., Corner of Harbour Pointe Blvd. South and Harbour Reach Drive to the corner of Harbour Pointe Blvd. North to Chennault Beach Road.

By submitting this form, you are agreeing to abide by the Program Guidelines and have your organization attend a Safety Orientation at City Hall. *

Yes
No

If you select "No", your application will not be considered.

GDPR Agreement *

I consent to having this website store my submitted information so they can respond back to me.
I do not consent to having this website store my submitted information and understand that I may not receive a response from the City of Mukilteo.

● Creates awareness for litter prevention	● Promotes community building
● Enhances tourism	● Elevates property values
● Prevents storm water pollution	● Keeps streets and sidewalks safer and cleaner
● Offers exercise with a purpose	● Makes Mukilteo beautiful!

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Adopt-A-Street Online Application

Mukilteo Adopt-A-Street Online Application