Collection Location Sign Up

Collection Location Sign Up
Register your site to become an official collection location. Please provide accurate details to help us review your application.
Location Name
Contact Person Full Name
First NameLast Name
Contact Email Address
example@example.com
Contact Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Collection Site Address
Street Address
Street Address Line 2
CityState / ProvincePostal / Zip Code
Types of Items Accepted
Other
Days and Hours of Operation
Estimated Weekly Collection Capacity (e.g., number of boxes, bins, or bags)
Accessibility Information (e.g., parking, wheelchair access, loading dock)
Do you require collection pick-up service or will you deliver items to a central location?
How did you hear about our collection network?
Additional Comments or Special Instructions
Should be Empty: