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Pickup Request Form
Please enable JavaScript in your browser to complete this form.
Step 1: Download and complete the following spreadsheet
Click to download the E-waste Precollection Inventory sheet
Step 2: Upload files
Upload the completed inventory sheet and any photos of the material
*
Click or drag files to this area to upload.
You can upload up to 10 files.
Step 3: Fill out the information form
Contact Name
*
First
Last
Contact Email
*
Phone Number
*
Alternate (backup) contact info [Name, Phone, Email]
*
Pickup site address
*
Please answer the following questions to schedule a pickup
Is this material stored in a warehouse, office, and/or storage room?
Warehouse
Office
Storage room
How far from the exit?
If the material is loose how can we transport it to the loading area?
carts only
can build on a pallet where it is stored and moved with a pallet jack
other
Is the equipment on the first floor? If not, is there an elevator?
Yes
No - but there is an elevator
No - and no elevator
SITE INFORMATION
Does your site have a loading dock or do we need a lift gate?
loading dock
no loading dock - lift gate is needed
Are there any size restrictions for the truck used for the pickup?
(We utilize everything from vans to semis depending on the location and volume of equipment.)
Open time
How early can we begin the pickup?
Closing time
How late can we complete the pickup?
Does MPC own the building or do we need to provide COI to the building management?
SAFETY INFORMATION
Safety rules - please check all that are required:
long pants
protective eyewear
steel toe shoes
no facial hair
flame resistant suit
other
Are we required to watch a safety video?
Yes
No
If yes - how long does this process take?
ADDITIONAL INFORMATION
Please note any other important details:
Submit
