Device Recycling Form

Device Recycling Form

Please fill out this form to reach us with your questions or concerns.
Full Name*

First NameLast Name
Email Address*
example@example.com
Phone Number*
+44 XXXX XXXXXX or 0XXXX XXXXXX
Device Type*
Device Description*
PhoneEmailNo Preference
Preferred Collection Date*

DayMonthYear
Date
Hour MinutesAM/PM Option
Device Collection Address*

Street Address

Address 2
CityState / ProvincePostcode
Recycling your old device with us will help reduce e-waste. If it can be repaired, it may be donated for reuse. If not, it will be stripped for parts or recycled responsibly. As a thank you, you’ll receive 10% off your next repair or service with NE Tech Repair.
YesNo
Lead Source
Ticket Subject
Assigned To
Queue
Priority
Should be Empty: