AAH Application Form

Official Name of Person/Organization
Applicant Name*
First Last
Title
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Home Phone
Office Phone
Email Address
Other Contacts
Name*
First Last
Home Phone
Office Phone
Email Address
Please list section of highway that you would consider adopting. Your adoptable section will be based upon availability and the rules and regulations of the Adopt-A-Highway Program. Adoption may be allowed or refused in the sole discretion of The Mississippi Transportation Commission.
District
Route
Once your application is received, you will be contacted by your district Litter Prevention Coordinator.
County
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