Intake form

Name *

Email address *

What type of location are you requesting a pickup from?

Please select at least one option.

Home

Apartment

Business

How many bags or boxes do you have?

What types of containers will you be recycling?

Please select at least one option.

Plastic Bottles

Cans

Glass Bottles

What date and time would you prefer for pickup?

Do you have any special instructions or notes for the pickup?

Which service or services are you interested in?

Please select at least one option.

Bottle and can collection

Sorting and returns handling

Donation-based recycling

Community impact recycling

Additional questions or comments

4 U Recycling