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Adopt-a-Highway Application Form

The Township started an Adopt-A-Highway program for environmentally conscious citizens to contribute to a cleaner and more beautiful Township of Huron-Kinloss roads system. Please complete this application form to identify what roadway you would like to adopt.

Group or Individual Applicant Name

Mailing Address

City/Town

Postal Code

Email Address

Phone Number

Cell Phone Number

Township road being adopted

Starting point of road section being adopted

End point of road section being adopted

In accordance with the Municipal Freedom of Information and Privacy Act, personal information is collected under the authority of the Municipal Act, 2001 and will only be used for the purpose of responding to your adopt-a-highway application form. Questions about the collection of the personal information may be addressed to the Clerk at the Township of Huron-Kinloss, 21 Queen Street, P.O. Box 130, Ripley, ON, N0G 2R0 or (519) 395 3735.

Signature

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Date