Company

Environmental Relations

WEEE Contact Submission

Company:

Pickup Address:

Company Name *

Company Name *

Address *

Address *

Post Code *

Post Code *

City *

City *

Country *

Country *

Business Hours *

Business Hours *

Contact Person:

Contact Person:

Name *

Name *

Telephone *

Telephone *

Email *

Email *

Shipment:

Type of Equipment *

Kind of Package **

Quantity *

Weight *

(please add detailed list of shipment units if available)

(** pallets, grid boxes, etc.)

List of Materials/Comments