PGH Mobile Toolbox Intake Form

PGH Mobile Toolbox

Volunteer Coordinator Information

First Name*:

Last Name*:



Project Information

Please select your workday date. Please note that you can only choose one day per intake form. The PGH Mobile Toolbox is available Friday and Saturdays, May through October. For workday dates that fall outside of the regular availability, contact the Toolbox Coordinator at 412.361.2099 ext. 7# or

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- Available
- Booked
- Pending

Start Time:
*The PGH Mobile Toolbox will arrive 15 minutes before your selected start time

End Time:
*The PGH Mobile Toolbox will leave at the end time, so please consider site clean up as part of your workday.

Location of your project:
*This can be an address or street intersection:

Please provide parking instructions for our Hauler:
*We will need at least 40 feet to park the truck and trailer

What community or neighborhood is this workday serving?

Where is the nearest restroom for volunteers?

Describe your project in 3 sentences or less:

How many volunteers do you predict will participate in your workday?

* Please select the activities that apply to your workday

What is the name of your project?

Does it have a mission or goal? If so, please explain.

Does your workday contribute to a larger project or program? If so, please explain.

By signing this form, I agree to release Grounded Strategies, and associated program contractors (collectively “PGH Mobile Tool Box”) and I agree to indemnify and hold the PGH Mobile Tool Box harmless from all claims, damages, or actions of any kind which might result from my participation in or attendance at PGH Mobile Tool Box volunteer days or programs, resulting from any of PGH Mobile Tool Box acts or omissions whether negligent or otherwise.

By signing this form, I assure that no volunteer under the age of 18 will operate or handle any power tools.

By signing this form, I confirm that I have legal access to your site and your workday activities are appropriate for volunteer participation.