Tool Bank Loan Request

Tool Bank Loan Request
Your Information
Organization*
Responsible Party*

First NameLast Name
Address*

Street Address Line 2

CityState / Province

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

MonthDayYear
Date
Purpose and/or address of cleanup/project*

Street Address Line 2

CityState / 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)*
Are you requesting these supplies for a Litter League cleanup?
Tool/Supply Needs
Tool Pickup Date*

MonthDayYear
The Tool Bank is open weekdays 9am - 2pm.
Tool Pickup Time*

Hour Minutes

AM/PM Option
Tool Pickup Time*
Tool Drop-off Date*

MonthDayYear
Tools must be returned the next open day following your cleanup/project.
Tool Dropoff Time*
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.
Would you like litter grabbers, if available?
Litter grabbers are in limited supply. If you would like them on your cleanup, please choose Yes from the dropdown and we will loan as many as possible to your effort, with a maximum of 1 per volunteer.

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. If you want to request more than 30 litter grabbers, please call (901) 636-4410.

	Quantity Requested
Broom - Push
Broom - Regular
Clippers - Lopper
Garden Fork (max. 6)
Garden Hoe
Gloves (Pairs)
Litter Grabber (max. 30)
Post Hole Digger (max. 2)
Rake - Garden
Rake - Leaf
Safety Vest
Saw - Pruner
Shovel - Dirt (Flat Head, for moving material)
Shovel - Sharpshooter (Narrow spade, for digging)
Shovel - Scoop (Large base, for moving light material)
Shovel - Spade (Pointed, for digging)
Swing Blade
Trowel - Fork
Trowel - Spade
Wheelbarrow (max. 2)

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*

MonthDayYear
Date
Should be Empty:

Tool Bank Loan Request

Your Information

Cleanup/Project Information

Tool/Supply Needs