Tektronix Recycle Program Request Form

* required fields

Questions or Comments?
If you have questions that were not resolved by your Recycle Coordinator, please contact Tektronix.

Purpose for Return^*	WEEE Compliance/Final Disposition Sales Promotion
Promo #
Certificate of Destruction (COD) required^*	Yes No
First Name^*
Last Name^*
Company Name
Pickup Address^*

City^*
State/Region^*
Postal Code^*
Country^*
	(If there are multiple locations. Please note it in the Special Instructions field and we will contact you.)
Product Ready for Pickup Date
Phone^*
Email^*
Package(s) Details
Number of Package(s)
Total dimensions of all boxes	L X W X H cm
Total weight of package(s)	kg lb
Is the product on pallets?	Yes No
Is there a dock door?	Yes No
What are the shipping hours?
Special Instructions
The information provided in this registration form will be used for the sole purpose of the Tektronix Recycle Program. By submitting a pickup request, you are acknowledging acceptance of the program terms and conditions.

Package(s) Details