eWaste Form

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Have an old copier or printer needing disposal?

Please just fill out the form below and someone will contact you as soon as possible.

Company(required)

First Name(required)

Last Name(required)

Phone Number(required)

Email address(required)

Address(required)

City(required)

State(required)

Machine Make(required)

Machine Model(required)

Meter

Are There Additional Machines For Pickup?(required)

Yes

Description of Additional Machines

Help Us Stop Spam(required)

This field should be left blank

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