Volunteer Service Project Request Form

Organization *

Contact Name*

Email*

Phone*

Date & Time Requested for Project*

Preferred Project Area

Athletics Department Education Department Performing Arts Department Options Department (high school mentoring) Construction and Building Projects

Choose all that apply

Number of Group Members*

Age Range of Group

Please follow this link to view the Group Service Project Liability Waiver and sign below. Only the group leader must sign for the whole group. Thank you!

UIF GROUP SERVICE PROJECT LIABILITY FORM

Liability Waiver Signature: Please review form above and sign*

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Use your mouse or finger to draw your signature above

Reason for requesting service project with Urban Impact:

(i.e. church-wide service day in Pittsburgh; traveling team coming into town; community service; etc.)

Special Skills of Group or General comments: