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* 1. First name:

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* 2. Last name:

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* 3. Email:

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* 4. Are you participating in the Sustainable Pittsburgh Challenge?

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* 5. Where will you be monitoring?

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* 6. Monitoring Address(es):

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* 7. Neighborhood(s):

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* 8. Two of the air quality monitors we provide require a protected, outdoor location with access to a power source (covered porch, picnic table with a weather-proof covering, etc.).  The monitors can be placed near each other under one protected location. Will you be able to make this accommodation?

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* 9. Our next cohort starts on Thursday, August 16th and ends on Tuesday, September 11th.   Our meetings typically start at 1pm and last two hours. Are you interested in being placed on a wait-list for the August cohort? Please realize participation in the Low-Cost Monitoring Project is a time commitment. We ask participants to record daily and submit data each week. Being unavailable for longer than one week is not acceptable.

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* 10. Are you interested in recruiting for a neighborhood/organization based cohort?  We encourage recruiting at least five colleagues/neighbors.  Our team will come to your location to provide our expertise and equipment.

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* 11. How did you hear about the ROCIS Low Cost Monitoring Project?

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* 12. What do you hope to gain from the ROCIS Low Cost Monitoring Project?

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* 13. Any comments or questions?

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