Green Event Materials Request

Name of Event

Event Date

Event's Sponsoring Organization

Pick-up / Drop-off Locations

Pick-up Date (Deramus is only open Wed-Sat 9am-5pm / OP open Tues-Sat 8am-4pm)

Drop-off Date (Deramus is only open Wed-Sat 9am-5pm / OP open Tues-Sat 8am-4pm)

ClearStream Recycling Unit ($3 Each)

ClearStream Recycling Bags ($0.50 Each)

Ripple Glass Home Recycling Bins ($3 Each)

Paper Recycling Bin ($3 Each)

Name *

Phone

Email

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Address Type

Relationship to Event*

Event Location *

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Event Website

Event Type *

Estimated Number of Attendees *

Event Schedule/Hours *

How did you hear about us? *

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