Online Application – Adopt A Street In Haiti

Name *

First

Last

Email Address *

Telephone Number *

Which street would you like to adopt? *

Please review our list of available street or pick a street near you. The adopt street needs to be cleaned at least once a month

Please provide a brief description about you and tell us why you chose to adopt a street in Haiti *

Terms & Agreement *

I agree to the terms below

The purpose of the Adopt-A-street program is to encourage community residents and organizations to adopt a street and keep it litter free. Your participation is in effect for a two year period.

The adopted areas are to be cleaned at least once a month. Immediately following the clean-up, the individual/group representative will email (adoptastreetinHaiti@gmail.com) with the following information: individual/group name, where the clean-up occurred, the total number of people participating, the total number of hours worked, and any special trash pickup requirements and pictures along with video footage.

The individual/group will place filled trash bags in a site dumpster, if available, or as directed by the Public Works Department. Remove litter during day light hours only and any hazardous situations or conditions shall be immediately reported to the police. All participants must wear safety vests at all times during the litter removal activity.

We may suspend or revoke your participation in the adopt a street program if you fail to clean your adopted street or for any false, deceptive or fraudulent statement in the application or in any other information submitted.