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Receycle E-waste Request Form
Name
:
*
Email:
*
Phone:
*
Address:
*
City:
*
State:
*
What devices do you need to be picked up? (check all the apply)
Computer/Monitor
Scanner/Copier/Fax
CD/DVD
Televisions
Phone/Cell Phone
Other
Direct Support, free pickup to the following cities. Azusa, Glendora, San Dimas and La Verne.
Please give us any details that would help explain your needs. Some electronics may be reused.
ASSOCIATED TECHNICAL SOLUTIONS 6820 LA TIJERA BLVD, LOS ANGELES CA 90045
