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Contact Details

First name *

Surname *

Title *

Company name *

Postcode * find

Phone number and extension *

Fax number

Email *

Equipment Details

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Package and Site Details

Equipment availability Choose one... De-installed and ready to collect Within 2 weeks Within 1 week 1-3 months 3-6 months More than 6 months

Equipment access Choose one... Ground level access Access via goods lift Difficult access

Site access Choose one... Onsite parking Street parking

Additional Services

Certified recycling of equipment with no market value? Choose one... Yes No

Data Security Requirements Choose one... None-performed in-house Drive formatting Level one overwriting method Physical destruction Higher level overwriting method

Additional manpower needed for collection? Choose one... Yes No

De-installation/Rack removal required? Choose one... Yes No

Other Notes:
Please enter any additional information that may be important