Pittsburgh Grocery Delivery sign up form
Hello Pittsburgh Residents!
We are having a FREE Grocery Delivery service opportunity for Pittsburgh residents that have a high risk of contracting the Coronavirus. As of now, it is very difficult for senior citizens and people with pre-existing medical conditions to buy their own groceries. Every time they leave their house, they put themselves at major risk. This service will allow them to receive their groceries without leaving their homes. Programs like this have been initiated in many parts of the world and it has been proven effective in slowing the spread of the virus.
How our program is going to work -
The amazing thing about our program is that users DO NOT have to pay any extra delivery fees in order to use this service. Anyone using this service will only have to pay the cost of the groceries.
The delivery process is very simple: After a volunteer and a resident are matched, the volunteer will receive the resident’s phone number, address, and grocery list. After this, the volunteer will buy the groceries and deliver it to the resident. Then, the resident will have to pay the volunteer using a payment option that they both agree on.
There will be two google forms. One google form will be for volunteers and the other one is for residents who need assistance. Both of these google forms will ask for basic information such as name, phone number, and preferred way of payment. After you submit your form, we will match a volunteer with a resident. They will set up a time and date for delivery and discuss other minor details.
It is our job to make sure that volunteers have the easiest process possible. We will make sure volunteers travel the shortest distance in order to make it more convenient for them. This program is a high school project and is sponsored by The Community Foundation of USC. As part of this project, the community foundation will give volunteers 10 dollars for every 3 deliveries they make in order to repay them for their kind service. High School students also have the chance to earn volunteer hours through this service which means they can complete their school requirements if necessary. Please contact
if you have any other questions. Thanks a lot and let's keep our community safe!
This is the volunteer sign up form -
What is the reason you will be needing assistance for this grocery service?
Grocery list (please list each item on a new line and try to make the list as small as possible to make it easier for our volunteers)
preferred way of payment (please select all that apply)
Which district do you live in?
Thanks for signing up! We will contact you shortly
If you have any questions, contact
A copy of your responses will be emailed to the address you provided.
Never submit passwords through Google Forms.
This form was created inside of Upper St. Clair School District.