Kids, Cans & Cash Can Pick-up

2. Please use this form for can pick-up

   Please only one pickup per school per month. If special arrangements need to be made please contact: Lorelei Elkins 336.641.2082 lelkins@guilfordcountync.gov or Laura McCoy 336.688.9316 Laura.McCoy@highpointnc.gov

   Please only one pickup per school per month. If special arrangements need to be made please contact: Lorelei Elkins 336.641.2082 lelkins@guilfordcountync.gov or Laura McCoy 336.688.9316 Laura.McCoy@highpointnc.gov

4. 

5. 

7. Name*

9. School Name*

11. Contact E-mail*

12. Phone Number

14. Location*
    -- Select One --High PointGreensboroGuilford County (other than High Point and Greensboro)

15. Number of Bags to be Picked Up*

17. Location/ Instruction for Bags to be Picked Up

    Will the bags be left in the hall, gym, by the carpool circle? Will we need to contact someone before gathering them?

19. Preferred Date and Time for Pickup*
    Preferred Date and Time for Pickup

    Preferred Date and Time for Pickup

20. Please Verify:*

    1. Only one pickup per month (unless other arrangements have been made)
    2. Bag all cans in clear bags
    3. CLEARLY mark all bags with school name (sharpie is fine)
    4. Have cans in an accessible location

22. Alternate Date and Time for Pickup*
    Alternate Date and Time for Pickup

    Alternate Date and Time for Pickup

24. Other Alternate Date and Time for Pickup
    Other Alternate Date and Time for Pickup

    Other Alternate Date and Time for Pickup

Leave This Blank:


25. 1. Receive an email copy of this form.
26. Email address

    This field is not part of the form submission.

27. Submit

* indicates a required field