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
*
1
2
3
4
5
6
7
8
9
10
11
12
:
Hour
00
10
20
30
40
50
Minutes
AM
PM
AM/PM Option
Special instructions
Any enquiries, please contact
admin@algim.org.nz
Submit
Should be Empty: