guide

Organization Name:

Address:                                         

City:

State:                                               

Zip Code:

Phone Number:                                

Fax Number: 

Web page Address

Material Accepted: (List, if necessary use a continuation page)

Reusable Items for sale: (List, if necessary use a continuation page)

Tell Us About Your Organization     ( )Profit   

( )Nonprofit

If Nonprofit Please List Mission Statement:

 

Background Information: (Please Limit to Two Sentences)

 

Do you accept drop-offs or pick up merchandise:

( )Free Pick-Up   ( )Charge to Pick-Up   (

)Free Drop-Off   ( )Charge to Drop-off

Drop-Off

Locations:                                        

Phone Number to arrange Pick-Ups

                                                                         

(      )