E-Waste Form

• What electronic items do you want to dispose of? *
  Air Conditioning Unit Computer CRT Monitor Digital Projector Fan Heater LCD Monitor Miscellaneous cables Overhead Projector Phone Printer Television Video/DVD Player Other
• If other *
• Is the item working and able to be reused?
  Is the item working and able to be reused?

  Yes No
• UOW Asset Number
• Serial number
• Make & model
• Campus location
  Wollongong Campus Innovation Campus Shoalhaven Campus Other Campus
• If other
• Item is stored in building and room number
• Contact person name

  Contact person name * First Last
• Contact person email *
• Contact person phone
• Comments