1. Adopt-a-Spot group number

   Leave it blank if you're not sure

2. Adopt-a-Spot group name*
3. Group Coordinator title*
4. Group Coordinator first name*
5. Group Coordinator surname*
6. Delivery street address*
7. Suburb*
8. State*
9. Postcode*
10. Contact phone number*
11. Email*

12. Clean-up items needed

    Please be mindful of how many items you request as we wish to reduce waste and you may be able to supply some of the items yourself.

13. Orange bags
14. Gloves - extra-small size
15. Gloves - small size
16. Gloves - medium size
17. Gloves - large size
18. Gloves extra-large size
19. BBQ tongs
20. Sharps container (small)

    All groups must have a sharps container for dangerous items

* denotes a required field.