Recycling Drop-Off Request


Please fill out the information below to schedule a recycling drop-off.  Call us at (913) 681-3333 Ext. 4, if you have questions.

Please provide the following contact information:  (Required)

First Name
Last Name
Title
Company
Street Address
Address (cont.)
City
State
Zip/Postal Code
Work Phone
FAX
E-mail
URL

Select any of the following options that apply:

Desktops         Laptops          Tablets          PDA's          
Printers         Monitors         Servers          Cell Phones    
Audio Equipment  Video Equipment  Other            

Desired date of drop-off?

  -- mm/dd/yy

Desired time of drop-off?

  -- hh:mm:ss am/pm

Estimated number of units to be dropped off?

 

Briefly describe the condition or any other important information pertaining to the equipment:

 


Copyright 2011 G3 Eco-Tech.  All rights reserved.
Revised: 12/08/11