Fill out this form to request a pickup of departmental equipment for recycling. This service is provided free of charge to the University of Rochester community. Please keep all equipment secured until pickup. Contact InformationName*Phone Number*Email Address* Department*Alternate Contact NameAlternate Contact Phone NumberAlternate Contact Email Address EquipmentEnter the number of each type of equipment to be picked up.Desktop ComputersLaptop ComputersMonitorsTVsPrintersPrinter Size* Large Small Loose Hard DrivesKeyboardsMiscellaneous Equipment(e.g., cables, peripherals, phones, mobile devices, etc.)Pickup InformationLocation*Include building, floor, and room numberSpecial Pickup Instructions*Pickups can be completed Monday - Friday, 9:00am - 5:00pmAdditional Comments This iframe contains the logic required to handle Ajax powered Gravity Forms.