Lift Lodi Outdoor Project Request Form
This project request form is for our elderly or disabled residents needing assistance during Our Annual Day of Service on May 20, 2023. These projects will need to be for the City of Lodi & Town of Lodi only.
Sign in to Google to save your progress. Learn more
Name *
Phone Number *
Email Address
Address of the Home/Project Site *
Location of Address
Clear selection
Please describe the full scope of your outdoor project. (Examples: raking leaves, weeding, planting flowers (you provide), mulching (you provide), trimming trees/hedges, cleaning debris, clean gutters, outside painting (you provide), outside window washing)
What tools or equipment will be supplied by the requester?
Please list the supplies you will need provided by the project team:
What length of time do you anticipate the project will take?
Clear selection
Will volunteers have access to an on-site restroom?
Clear selection
I am willing to have a volunteer from Lift Lodi come to my home to assess/review the project needs.
Clear selection
I understand that the submission of this request does not guarantee that this project will be selected for the Day of Service.
Typed Signature and Date Signed
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy