Pick Up Request
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Full Name
*
First Name
Last Name
Contact Number
*
Please enter a valid phone number.
Email Address
*
example@example.com
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please provide a description of items you are requesting we pick up, type of item and number.
*
Description of items you request STLHELP to pick up
Please take a photo of the items you have for pick up
*
Submit
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