RMC Online Registration Form

Type of Drop-Off *

Permanent public drop-off location. (These locations will be included in the RMC searchable database.)
Non-public drop-off location. (Your locations will be excluded from the RMC database. Appropriate for schools.)
Set up short-term campaign.

Contact Name *

Organization Name *

Building Name

Address *

City *

Province

Postal Code *

ie: A0A 0A0

Phone Number *

E-Mail Address *

Organization Facebook

ie: https://www.facebook.com/RecycleMyCell/

Organization Twitter

ie: @RecycleMyCell

Please indicate what best describes your organization *

Materials & Agreement *

Please review the Terms and Conditions which outline the responsibilities you are undertaking by hosting a drop-off location, as well as our responsibilities to you.

Please send me RMC posters & brochures

Organization #1 - Name *

Organization #1 - Building Name

Organization #1 - Address *

Organization #1 - City *

Organization #1 - Province *

Organization #1 - Postal Code *

ie: A0A 0A0

Organization #1 - Phone Number

Organization #2 - Name

Organization #2 - Building Name

Organization #2 - Address

Organization #2 - City

Organization #2 - Province

Organization #2 - Postal Code

ie: A0A 0A0

Organization #2 - Phone Number

Organization #3 - Name

Organization #3 - Building Name

Organization #3 - Address

Organization #3 - City

Organization #3 - Province

Organization #3 - Postal Code

ie: A0A 0A0

Organization #3 - Phone Number