*1.What is your name(Required.)

*2.What's your email address?(Required.)

*3.Which company do you work for?(Required.)

*4.Date of drop off(Required.)

*5.Location of drop off, i.e. name of grocery store and state(Required.)

*6.Approximate weight of plastic material dropped off? (You can weigh this at home or use your best guess. Please submit weight estimate in ounces.)(Required.)