Pull the Plug
Recycling Form

Today’s Date - 05/24/19

Co-op Information
Recycle Month/Year
Person completing the form
First Name
Last Name
Co-op member information
First Name
Last Name
Mailing Address
Daytime Phone Number
Alternative (e.g. Cell Phone) Number
REC account number (if known)
Email address
Pickup location
Check to copy address if pickup is the same as above.
Location of appliance(where in house)
Nearest cross street
Requesting recycling of the following appliances
The maximum number of appliances eligible for free pickup and recycling by the REC is 3. Additional items may be picked up during the same trip at the member’s own expense.
Window A/C  
Have you participated in a recycling program offered by your electric cooperative in the past year?


E.g. Any non-program appliances to pickup (at member’s expense, $20 each(outside) or $50 each(inside), such as computer, TV, water heater, stove, dishwasher, microwave, washer, dryer)
E.g. Alternate phone number
E.g. best time to call during business hours