Project Submittal Form

Organization

Note: Your organization must be a non-profit (510(c)3), a neighborhood/community group, a school or a public agency.

Name of organization *

Street address *

City *

Zip *

Phone *

Organization's website *

Please indicate which social media platforms your organization uses. *

Facebook

Twitter

Instagram

None

Liability insurance: All agency or non-profit project sponsors must have adequate liability insurance for volunteers. Please confirm you have adequate liability insurance by entering your initials in the box below.

Initial here *

Contact Person for CSD Project

First Name *

Last Name *

Email Address *

Best phone number *

Project Information

Project name *

Brief description of what volunteers will do at your project. *

Project Location

Project Street Address (Note: Please be specific. Project must be located in Pleasant Hill) *

Specific meeting location (e.g. meet at the picnic tables facing Gregory Lane) *

Project Requirements

Estimated number of volunteers needed: *

Age requirements: Please select most appropriate age range for your project. *

All ages. Children under 14 must be accompanied by an adult.	Minimum age 10. Children under 14 must be accompanied by an adult
High school ages or older	Adults only
Other Other

Physical requirements (e.g. "must be able to lift 50 pounds, or "must be able to walk a half-mile to the site." *

Other requirements (please check all that apply) *

Volunteers should bring (please check all that apply) *

Gardening tools (clippers, pruners, rakes, shovels)	Cleaning tools (brooms, dust pan, dust cloths, cleaning supplies)
Wheelbarrow	Trash clean-up tools (buckets, trash bags)
Painting tools (paint brushes, paint pan)	Carpentry (hand) tools
Work gloves	Other: Other:

Project Leader

Please provide the contact information for the person who will serve as the project leader at the site on Community Service Day.

First Name *

Last name *

Cell phone *

Email address *

Comments/Additional Information

Work clothes you can get dirty	Closed-toe shoes for safety
Long pants (no shorts)	Long-sleeved shirt
Hat	Sunscreen
Other: Other: