Chi Shred Request Form
Please fill out your details and preferred shredding date to schedule your shredding service.
Full Name
*
First Name
Last Name
Company Name
Email Address
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Pick Up Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Preferred Pick Up Date
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
What Will You Be Using For Your Documents?
Standard Trash Bag
Box
Multiple Bags/Boxes
Other
How Many Bags or Boxes Do You Have?
What Type Of Shredding Service Is This For?
Personal/ Household Documents
Business Documents
Moving/Clean Out
Other
Are The Documents Ready For Pick Up?
Yes
No
Additional Pick Up Details or Special Instructions
Submit Request
Should be Empty: