Penndot Adopt A Highway

Agreement Number must be numeric. Maximum 8 characters allowed for Agreement Number. Please enter an Agreement Number.

Please enter a First Name. Maximum 65 characters allowed for First Name. First Name cannot contain the following characters: < > ' or &#.

Please enter a Last Name. Maximum 65 characters allowed for Last Name. Last Name cannot contain the following characters: < > ' or &#.

Please enter a Phone Number. Phone Number must be all numbers, beginning digit must be 2-9.

Please enter an Email Address. Email Address is not proper format. Email Address cannot contain the following characters: < > ' or &#. Maximum 65 characters allowed for Email Address.

Number of Medium Participants is a required field. Medium Participant count must be a whole number. The sum of participants must be greater than 0.

Number of Large Participants is a required field. Large Participant count must be a whole number. The sum of participants must be greater than 0.

Supply Pick Up Date is a required field. Test Use mm/dd/yyyy for Supply Pick Up Date. Pick Up Date must not be a past date. Supply PickUp Date is not within 3 days of Collection Date.

Collection Event Date is a required field. Use mm/dd/yyyy for Collection Event Date.

Comments cannot contain the following characters: < > ' or &#. Maximum 250 characters allowed for Comments. Illegal characters detected in comments. Please only use letters, number, and standard punctuation.