Register your Organization with eWaste Alternatives...

Thank you!

Please create an account (link at top of page) BEFORE submitting this form! When asked, select the 'EWA Donor' role.

If you have any questions at all, just call (207) 872-2615

Your email address

Your user name

Organization: *

Name of parent/primary responsible party or company

Your Name/Direct Contact Name: *

Your first name: *

Last name: *

Your Title:

Your Phone #: *

Billing Address: *

City: *

State: *

Zip: *

Does your organization accumulate electronics at multiple sites?: *

Does your organization have an IT lifecycle? If so what is it?: *

Rough estimate of the number of devices you pull from service in one year?: *

Does your organization have a formal 'Sustainability Committee'?: *

Accept Terms & Conditions: *

Yes

By selecting 'Yes' you agree to all these terms and conditions. Terms and Conditions document link is available at the bottom of this form.

Additional Notes:

Please enter any other information you think helpful, such as different/multiple storage area addresses, contact or billing information etc...