Safe Electronic Equipment Disposal Form

Bold fields are required.

Requests for a collection must be placed one week or more prior to the planned collection date. Requests after that time will be assigned to the next collection.

Detailed Instructions can be found on the Information Security Services.

Contact Information

This information pertains to the person filling out this form.

First Name
Last Name
Confirm E-mail
Phone Number
This program is for University Equipment only.
Is all the equipment University owned?

Equipment Information

How do you wish to supply the information for your equipment?

  • To manually enter items into this webform.
  • To use a template.

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If you are the owner of this site and you would like to print the page as it appears online, please refer to the file "QuickStart.html" for instructions.