ROCIS Mon/Yough Cohort Interest Survey LCMP Mon/Yough Cohort Question Title * 1. First name: Question Title * 2. Last name: Question Title * 3. Email: Question Title * 4. Where are you interested in monitoring? Home Workplace Both Question Title * 5. This cohort will be focused on the Mon/Yough area (such as Elizabeth Twp., Elizabeth Boro, Clairton, Sutersville, West Newton, and Jefferson Hills). What municipality or neighborhood(s) do you plan to monitor in? Question Title * 6. Monitoring Address(es): Site #1 STREET: Site #1 MUNICIPALITY: Site #1 ZIP: Site #2 STREET: Site #2 MUNICIPALITY: Site #2 ZIP: Question Title * 7. One of the air quality monitors requires a protected, outdoor location (covered porch, picnic table with a weather-proof covering, etc.) with access to a power source. Will you be able to make this accommodation? Yes No Please specify where you plan to place the monitor, and whether you have an outdoor outlet, or need to run an extension cord from inside Question Title * 8. The Mon/Yough Cohort starts Thursday September 12 and ends Thursday October 10. The 2-hour kick-off meeting is mandatory and will convene at the Elizabeth Twp. Community Building from 6 - 8 PM. Review LCMP Expectations .Do you have availability and interest to meet these expectations and participate in the Mon/Yough Cohort? Yes Maybe No Question Title * 9. Keep me informed of opportunities to participate in the future. Yes No Question Title * 10. How did you hear about the ROCIS Low Cost Monitoring Project? Question Title * 11. What do you hope to gain from participating? Question Title * 12. Any comments or questions? Done