Required fields are marked with asterisks (*)

Adopt-A-Street Application

Please fill out the fields below.

Privacy Statement: All information collected on this form is strictly for the use of the City of St. Catharines Volunteer Program and such information will remain private and confidential and will be for program use only. This is an application form only and does not endorse or approve your request.

Name of Group/Organization

Contact Name

Address

City and Province

Postal Code

Phone Number

Street that you would like to adopt (please indicate the cross streets that area is between)