Shred Alaska - Contact Form

SERVICE REQUEST FORM
Contact Information
Have you had Shred Alaska service onsite before? Yes No
Acct # (if applicable)
Business Name:		*
Billing Address:
Service Address:		Same as Billing Address
Primary Contact Name:		*
Primary Contact Phone #:		*
Alt Contact Name:
Alt Contact Phone #:
Email Address:		*
Fax:

Job Request Info
Bin service
	# of Lg bins full
	# of Sm bins full
	Any Extra materials?
	Bin location notes
File Purge
	# of standard banker boxes
	# of Lg banker boxes
Other
Where materials are located (at ground level? Stairs?)

I have reviewed the "Can and Can't shred" page and have confirmed that the documents I am requesting to be destroyed comply with all requirements set forth by Shred Alaska, Inc.

Preferred method of contact		phone email

A confirmation of this request will be sent to the provided email address. Please contact us if there are any changes, corrections, or additions to your request.


		* Denotes fields that are required

SERVICE REQUEST FORM