Penndot Adopt A Highway
Request Supplies, Report a trash collection and apply for the Adopt A Highway Program
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If your email address in the system is not current, be sure to update before submitting a cancellation. Click Edit Contact to update your email address.
If you do NOT have access to the information on file contact your
local AAH County Coordinator
to change your contact information.
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Agreement Cancellation
*Last Name
Please enter a Last Name.
Maximum 50 characters allowed for Last Name.
Last Name cannot contain the following characters: < > ' or &#.
*Zip
Zip Code is a required field.
Zip code must 5 numbers only (#####).
*Last 4 Digits of Phone Number
Phone is a required field.
Phone Number must be all numbers, beginning digit must be 0-9.
*Agreement Number
Agreement Number must be numeric.
Maximum 8 characters allowed for Agreement Number.
Please enter an Agreement Number.
Cancellation Information
Cancellation Reason:
---Select---
Group disbanded
Time constraints
Physical limitations
Environmental hazards
Lost interest
Other
Select a Cancellation Reason.
Cancellation Comments:
Cancellation Comments are required when Cancellation Reason is 'Other'.
Cancellation Comments cannot contain the following characters: < > or &#.
Confirm Cancellation
Are you sure you want to cancel this agreement?
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Confirm Renewal
Are you sure you want to renew this agreement for 2 years?
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Email Address Lookup
*Email
Email Address is a required field.
Maximum 65 characters allowed for Email Address.
Email Address is not proper format.
Email Address cannot contain the following characters: < > ' or &#.
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Resend Cancellation Confirmation Email
This Agreement has an existing cancellation request and is ineligible for this transaction.
Click 'Send' if you need your confirmation email resent. Contact your local county coordinator if you need assistance.
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