Tool Bank Request

Tool Bank Request
Your Information
Organization *
Responsible Party *

First Name Last Name
Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Email *
example@example.com
Phone Number *
Please enter a valid phone number.
Cleanup/Project Information
What is the date of your cleanup/project? *

Month Day Year
Date
Address of cleanup/project *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
How many adult volunteers will be participating? *
How many youth volunteers will be participating? *
Total volunteers
This number is auto-calculated and does not need to be entered.
Expected total attendance (volunteers and guests, if applicable) *
Tool/Supply Needs
Tool Pickup Date *

Month Day Year
The Tool Bank is open on Mondays, Thursday, and Fridays, 9am to 4:30pm.
Tool Pickup Time *

Hour Minutes

AM/PM Option
Tool Drop-off Date *

Month Day Year
Tools must be returned the next open day following your cleanup/project.
Tool Drop-off Time *

Hour Minutes

AM/PM Option
Do you need trash bags? *
Trash bags will be disbursed at the discretion of City Beautiful. Supplies limited.

Please enter the number you would like to request next to each tool below. We recommend one tool/trash bag per volunteer. If you do not need a tool, please leave blank. *

	Quantity Requested
Broom - Push
Broom - Regular
Clippers - Hedge
Clippers - Lopper
Garden Fork
Garden Hoe
Gloves (Pairs)
Litter Grabber
Post Hole Digger
Pruner
Rake - Garden
Rake - Leaf
Safety Vest
Saw - Bow
Saw - Pruner
Shovel - Dirt
Shovel - Pipe
Shovel - Scoop
Shovel - Spade
Swing Blade
Trowel - Fork
Trowel - Spade
Wheelbarrow

Do you have any additional comments about your request?
By submitting this request, you agree to hold the City of Memphis Government, including the Division of Public Works - Neighborhood Improvement and/or Memphis City Beautiful harmless in the event of any accident or injury by negligence or otherwise that you may suffer while utilizing the Tool Bank Loan Program.
Responsible Party Signature *

Clear
Date Signed *

Month Day Year
Date
Should be Empty:

Tool Bank Request

Your Information

Cleanup/Project Information

Tool/Supply Needs