Business Computer Recycling Service Form – GESMV

Company or Organization Name*
Address*
City*
Zip Code*
Primary Contact Name*
Contact Telephone*
Contact Fax*
Contact E-Mail*
Pick-Up Address (if different from above)*
Do you have a dock where the items will be located?*
- Yes
- No
If not, where will the items be located?
Will the items be together or in multiple locations?*
What are the days and hours available for pick-up?*
If not on a dock, is there a freight elevator and someone to help operate it?
Are there obstacles or special handling needs?*
What type of equipment will be donated?*
What is the approximate number of items?*
Will items be dry and clean?*
Do you want a certificate of destruction of data?*
- Yes
- No

Reach us by phone

Contact us, for more information on business & organization computer recycling.

Phone: 937-528-6536