Quote and Clear Booking Form

1
Email* This field is requiredWe need your email so we can send you info about your booking
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2
Your Name* This field is required
First Name
Last Name
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3
Mobile Number* This field is requiredOn site contact mobile number
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4
Company NameIf you're booking on behalf of a company pop the name in
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5
Brief description of waste* This field is requiredTell us a bit about your waste
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6
Address for quote?* This field is requiredStart by typing your address and select yours
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7
Extra items?Do you have any of the following items?
Mattress
Fridges
Air Con Units
Paint
Fluorescent Tubes
Tyres
No extra items
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8
Got any pictures of the waste?* This field is requiredUpload any images you've got it will help us to know what to expect
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9
Estimated Load Size* This field is requiredHow much waste do you think you have if filling up a Van? You can see our estimated prices below to give you an idea
Single Item (£50)
Mini Load (£60)
small Load (£90)
Quarter Load (£145)
Half Load (£210)
Three Quarter Load (£265)
Full Load (£336)
No Idea
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10
Anything else we need to know?If the fridge is up ten flights of stairs please let us know...
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11
Email
example@example.com
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12
Unique ID
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13
Preferred time for collection?* This field is requiredWhen is convenient for us to come and take a look?
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14
We need a card incase you go ahead* This field is requiredYou wont be charged unless you accept the quote and clear service but we need this in advance. No charge will be made, we just need to make sure your card is a valid UK credit or debit card.
My Bag
1
My Bag
Great Product Name
$20
Quantity:1
Size:Small
RemoveEdit
Great Product Name
$20
Quantity:1
Size:Small
RemoveEdit
Great Product Name
$20
Quantity:1
Size:Small
RemoveEdit
Great Product Name
$20
Quantity:1
Size:Small
RemoveEdit
ORDER SUMMARY
Total costGBP
Quote & Clear Booking - Authorisation
£0GBP+
Back
Total £0.00GBP
Please enter your Card Details you would like to use for the order if approved
First Name
Last Name
Credit Card Number
Security Code
Expiration Month
2019
Expiration Year
First Name
Last Name
Credit Card Number
Security Code
Card Expiration
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15
By submitting you agree to our T&Cs* This field is requiredStandard stuff, you'll only be charged if you accept the quote
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