Pickup Request

Please complete and submit this form to recycle your covered electronics that you no longer use FREE OF CHARGE.

Note: If computer equipment is not at the end of its useful life, we invite you to contact one of the EPRA-Québec selected reusers (see under the Service Providers menu).

Company Address

Company Name*

Address*

Street Address Address Line 2 City Postal Code

Telephone Number / Extension*

Email address*

Pickup Location

If different than company address.

Address

Street Address Address Line 2 City Postal Code

Phone

Pickup Information

Is this your first pickup request?*

Yes
No

Contact name for pickup*

Phone number*

of contact person

Access hours*

to the pickup site

Loading Dock

Yes
No

Lift?

Yes
No

Products are palletized or in bulk?

Palletized
Bulk

Number of pallets to pickup*

Please enter a number greater than or equal to 0.

4' X 4' X 4'

Additional information

Consent*

I understand that the following products are not accepted by the EPRA-Québec program:*

Floor-standing IT equipment (printers, copiers, multi-function devices, servers and other floor-standing devices)

Rack-mount servers

Electronic white boards

See the complete list of accepted products

Phone

This field is for validation purposes and should be left unchanged.