Locofone - Phone Collection

Locofone - Phone Collection
Contact Information
Name *

First Name Last Name
Email *
example@example.com
Job title *
Organisation *
Preferred Phone Number *

Area Code Phone Number
Alternative Phone Number

Area Code Phone Number
Physical address (for courier pick up) *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Order information
Number of phones to be recycled *
Number of cartons to be picked up *
Please mark cartons eg 1 of 4, 2 of 4 etc
Dimensions of each box in centimetres (Please list dimensions for each box if they are different) *
Weight of each box in centimetres (Please list weight for each box if they are different) *
Date available from *

Month Day Year
Date
Time available from *

: Hour Minutes AM/PM Option
Special instructions
Any enquiries, please contact admin@algim.org.nz
Should be Empty:

Contact Information