E-Waste Form

Name of contact person

First NameLast Name

Name of company (if applicable)

Phone Number

Format: (000) 000-0000.

E-mail address

Confirmation Email

Physical Address of Collection

Street Address

Street Address Line 2

City

Country

Where did your e-waste come from?

Other

Please select ONLY IF one of the following applies to the person or company which the e-Waste is coming from:

Please select ONLY IF you require one or more of the following (For corporate & SMME only). Please note, you may be billed additionally.

Please list the items which you would like us to collect:

Estimated quantity of items:

If you have images of the items or asset register files, please attach here

Browse Files

(optional)

Additional Notes (If any)

How did you find out about us?

From 1 July 2021, the Protection of Personal Information Act (POPIA) has been in full effect. The Act is designed to protect how organisations collect, use, store and process your personal information.

At EC e-Waste Management (Pty) Ltd, we are committed to protecting the personal information we collect from you and ensuring that it is only used for the purposes for which it was intended. Your personal information will not be shared with or disclosed to any third parties, except where such disclosure is required by law or necessary to comply with applicable South African legislation, regulations or registration requirements.

We remain committed to handling your information responsibly and in accordance with POPIA.

Thank you for your continued and loyal support.

E-waste Collection Form