2018 LCMP Interest and Screening Survey Question Title * 1. First name: OK Question Title * 2. Last name: OK Question Title * 3. Email: OK Question Title * 4. Are you participating in the Sustainable Pittsburgh Challenge? Yes No Maybe If yes, please indicate your organization/business/local government entity/school. OK Question Title * 5. Where will you be monitoring? Home Workplace Both OK Question Title * 6. Monitoring Address(es): OK Question Title * 7. Neighborhood(s): OK Question Title * 8. Do you have a preferred cohort? We typically have a cohort scheduled for each month of the year (January 2018-January 2019). Dates for each cohort will be posted on our website three months prior to the state date. Please indicate your preferred month(s) below. 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. OK Question Title * 9. 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? Yes No Please specify where you plan to place the monitors, and whether you have an outdoor outlet, or need to run an extension cord from inside OK Question Title * 10. How did you hear about the ROCIS Low Cost Monitoring Project? OK Question Title * 11. What do you hope to gain from the ROCIS Low Cost Monitoring Project? OK Question Title * 12. Any comments or questions? OK DONE