Waste Electrical and Electronic Equipment (WEEE) Returns

If you would like to dispose of your Polaron /Emitech branded product(s) under the Waste Electrical and Electronic Equipment Directive, please complete the form below and select the submit button upon completion. A company representative will respond to your request within two business days. On behalf of Quorum Technologies Ltd and the Environment we would like to thank you for the proper disposal of your waste electrical and electronic equipment products.

*	indicates required fields
*	First Name:
*	Last Name:
*	Email:
*	Phone:
*	Company Name:
*	Address:	Please insert full collection address
	Multiple return items will be addressed upon form completion with Company Representative.
*	Product Description:
*	Serial Number:
	Product Number:	e.g. SC7620
	Does your product(s) contain the WEEE label (crossed-out wheelie bin)?	Yes No Unknown
	Identify the seller from whom you purchased the product:
	Specify the date of your purchase of the product:
	Specify in which Country you purchased your product(s).	austria Belgium Cyprus Czech Republic Denmark Estonia Finland France Germany Greece Hungary Ireland Italy Latvia Lithuania Luxembourg Malta Netherlands Norway Poland Portugal Slovakia Slovenia Spain Sweden Switzerland United Kingdom other unknown
	Please provide the following details in order to properly plan for the collection of your product(s) at your facility. If the category is not applicable (N/A) to your site, please specify by typing N/A in the field provided.
*	Vehicle Restrictions:
*	Parking Restrictions:
*	Equipment Location within Building:
*	Site access security Restrictions, eg, special passes or clearances required:
*	Opening Hours:
*	Earliest Date of Collection:
	Handling Equipment (If Required):	e.g. a tail lift truck
	Additional Packaging Requirements:
	Health & Safety Certificate:	Please indicate any substances that may be hazardous to human health that have been in or remain in the equipment
*	WEEE Expected Boxes:	Please indicate the expected number of boxes you require us to collect
*	WEEE Expected Weight (KG):	Please enter - as close as is practical - the expected combined weight in kgs of the items for collection and, if packed, the external dimensions in cms
	If you have any questions about this form, please email sales@quorumtech.com