Source
Intake Form
Name of Organization/Company
*
Your Name
*
Your Email
*
Your Phone #
*
Area Code - Phone Number
How did you hear about us?
*
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Locations & Volumes
1. How many locations does your company have?
*
1–3 Locations
4–9 Locations
10-24 Locations
25+ Locations
2. What is your volume of material disposal per month?
*
A few boxes/Less than a pallet
A few pallets
A truckload
Multiple Truckloads
3. What is the frequency of disposals per month?
*
1 Pickup
2-9 Pickups
10+ Pickups
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Material & Reporting Needs
4. What kind of material do you have that you are looking to dispose of? (click all that apply)
*
IT Assets & Mobility
Telco & Network
Specialized Equipment
Critical or Raw Materials
Other
Special (20)
Other (15)
IT/Telco/Critical (25)
5. What are your current reporting needs? (click all that apply)
*
Financial reporting
Environmental impact reporting
Compliance and audit trails
Custom reporting capabilities
We don't require specific reporting
Other
None/Other (3)
Custom/Enviro/Compliance (10)
Financial (7)
6. When are you looking to start?
*
Immediately
30-60 Days
60+ Days
Other
Submit
Score
Number
Fit
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