Intake form

Help us serve you better

Name *

Email address *

What type of electronics are you recycling?

Please select at least one option.

Computers

Monitors

Laptops

Printers

Televisions

Mobile Phones

Tablets

How did you hear about us?

Preferred pickup date

Preferred pickup time

Do you require immediate assistance?

Location of the pickup (if applicable)

Any additional comments or instructions?

Additional questions or comments

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Bryan's tech E waste recycling