Adopt-A-Street Application

BEFORE submitting this application, please keep in mind:

• Not all locations are available, but KAB will work with your group to find a location in need.
• Your group must adopt at least ½ a mile of street within the City of Austin for two years.
• Your group must agree to clean-up litter along the adopted street at least four times per year.
• Your group will be responsible for the cost to produce and install each sign.
• KAB will work with the City of Austin to put up your sign after an agreement has been signed and payment has been received.
• KAB will provide your group with free supplies and safety guidelines, by request, if needed.

Location

I would like to adopt the following location(s), if available (please select top 3 choices):

CHOICE #1
Street Name:
Street Segment: (please describe the boundaries of the section you would like to adopt including the nearest street intersection)
CHOICE #2
Street Name:
Street Segment:
CHOICE #3
Street Name:
Street Segment:

Group Information

Group Name:		Type of Group:	(None) After-school Group Business Faith Based Informal Youth Group Neighborhood Non-Profit Other School Scout/Troop
# of Volunteers:
First Name:		Last Name:
Address:
City:		State:	AL AK AS AZ AR CA CO CT DE DC FM FL GA GU HI ID IL IN IA KS KY LA ME MH MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND MP OH OK OR PW PA PR RI SC SD TN TX UT VT VI VA WA WV WI WY	Zip:
Daytime Phone:		Evening Phone:
Email:		Confirm Email:
Alternate Contact
First Name:		Last Name:
Address:
City:		State:	AL AK AS AZ AR CA CO CT DE DC FM FL GA GU HI ID IL IN IA KS KY LA ME MH MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND MP OH OK OR PW PA PR RI SC SD TN TX UT VT VI VA WA WV WI WY	Zip:
Daytime Phone:		Evening Phone:
Email:

Comments

Tell us why you would like to adopt this street and what would make your group a great partner:

Keep Austin Beautiful, 55 North I 35, Suite 215, Austin, TX 78702
Telephone Number: 512.391.0617 / Fax Number: 512.391.0624