Bindicator Sign Up Form

Organization Name

Address

Contact Name (for admin purposes)

Contact email (for admin purposes)

Telephone Number

Website

Format required http://example.com

Fees charged

Yes

Accepted Materials (please list all)

Special requirements or restrictions for drop off

Is your facility accessible to people with disabilities?

Yes

Do you host special collection events for the public or upon request?

Yes

Do you offer pick-up service?

Yes

If yes, please provide contact information for bookings

Affiliation with provincial stewardship program (WEEE/MHSW)

Charitable partner (if applicable)

On behalf of my organization, I acknowledge that I have read and agreed to the Terms and Conditions for participating in the Bindicator, as outlined on the following page. I understand that listings in the Bindicator are for information purposes only. Listed organizations are not endorsed by or under contract to the Region for the services they provide. The Region may remove the listing at its discretion, at any time. I agree that my organization takes full responsibility for the proper disposal/recycling of goods dropped off at our listed facilities, in accordance with the information provided in this application. The Region is not responsible for processing or disposal costs associated with materials dropped off.

I accept