New Zealand

Join Online Toner Cartridge Recycling Collection Box Scheme

<div class="company-site">
				  		<div class="col-3">
					  		<label>Contact Name*</label>
					  		<input class="required" name="contact_name-{0}" type="text" placeholder="<Of who will make requests>"/>
				  		</div>
				  		<div class="col-3">
					  		<label>Contact Phone Number*</label>
					  		<input class="required" name="contact_number-{0}" type="text" placeholder="<Needed for courier service>"/>
					  	</div>
				  		<div class="col-3 last">
					  		<label>Email Address*</label>
					  		<input class="required" name="email_address-{0}" type="text" placeholder="<To make requests & receive confirmations>"/>
				  		</div>
				  		
				  		<div class="col-1">
					  		<label>Full Physical Street Address for Delivery/Collection</label>
					  		<input class="required" name="delivery_address-{0}" type="text" placeholder="<Street number & name, floor level, building name, etc>"/>
					  		<input name="delivery_address2-{0}" type="text" placeholder="<Suburb, city or town>"/>
				  		</div>
				  		<div class="col-1">
					  		<label>Location in Building for courier to Deliver/Collect*</label>
					  		<input class="required" name="delivery_location-{0}" type="text" placeholder="<Where the courier will collect/deliver>"/>
				  		</div>
				  		
				  		<div class="col-1">
					  		<label>Special Instructions</label>
					  		<textarea name="special_instrucations-{0}" placeholder="<Any other instructions.  																		Please note: You cannot use this form  to make requests.>">

Application to Join Online Toner Cartridge Recycling Collection Box Scheme

This form is for joining our recycling scheme only. Not for delivery/collection requests.

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