Electronics Sign-Up Form

School/Organization:
Address:
Telephone:
Fax:
Email:
Exact Event Location (on campus details):
Preferred Date:
Preferred Hours of Event:

Hands On Recycling agrees to provide the assistance and planning of recycling efforts on behalf of the school or local charity or listed above. Schools or local charities that collect will be paid upon completion of the assessment process. Collection will be removed by the end of the collection date. The above school or local charity has authorized Hands On Recycling to pick-up materials for recycling and further agrees to honor this agreement.

SCHOOL/CHARITY/CHURCHES SPONSOR AUTHORIZED REPRESENTATIVE (Name and/or Title):
Representative for Hands On Recycling:
Date of Agreement:	(mm/dd/year)