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Lift Lodi Residential Project Request Form
This project request form is for our elderly or disabled residents needing assistance during our Annual Day of Service on May 16, 2026.
These projects will need to be for the City of Lodi & Town of Lodi only.
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* Indicates required question
Name
*
Your answer
Phone Number
*
Your answer
Email Address
Your answer
Address of the Home/Project Site
*
Your answer
Location of Address
City of Lodi
Township of Lodi
Clear selection
Which outdoor projects would you like assistance with?
Light Landscaping (spreading mulch, weeding, planting, raking, light shrub pruning, soil & seeding
Window Washing (no ladders, first floor outside only)
Small Painting Project (must be outside)
Other (will need approval from our team)
If helpful, please provide a brief description of the work you're looking for.
Your answer
What tools or equipment will be supplied by the requester?
Your answer
What length of time do you anticipate the project will take?
up to 2 hours
2-4 hours
Clear selection
Will volunteers have access to an on-site restroom?
Yes
No
Clear selection
I agree to have a volunteer from Lift Lodi come to my home to assess/review the project needs.
Yes
No
Clear selection
I understand that the submission of this request does not guarantee that this project will be selected for the Day of Service.
I agree
Typed Signature and Date Signed
Your answer
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