Request a Pickup

Please complete the form below as best as possible.

Your Information

Your Name

Your Email

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Phone (i.e. 123-456-7890 Please Hyphenate)

Pickup Information

Requested Pickup Date

Please list all items to be picked up

Item Location on premises

(All items must be located in a garage, driveway or accessible outside area)

Additional information that we should be aware of?

Please upload a picture(s) of the item you would like picked up.

Choose files

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256 MB limit.
Allowed types: gif, jpg, png.

I was referred by Shelter House

How did you hear about us?