Application

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Reservation Form

Please fill out the following form and send to us. With any questions, please contact our office at (732) 396-0357.

If You're already our customer, please login first here *** All information for office use ONLY ***

Field with * are required

School / Organization information
Have you collected clothing for us before? *:	Yes No
School / Organization name *:
Address *:
Town *:
State *:
Zip code *:
County *:
Phone *:
Fax:
Contact Person Information
Contact person is required to contact our office a day before scheduled pick up to confirm
Contact Person name (available on pick up day) *:
Home phone:
Work phone:
Email address *:
Cell phone:
Login & password
Login *:
Password *:
Repeat password *:
Collection Information
Make check payable to:
Send check to *:
*** Requested date of collection:
*** Requested time of collection:	** SELECT TIME ** 8-9am 9-10am 10-11am 11-12pm 12am-1pm 1-2pm 2-3pm 3-4pm
We encourage you to include an alternative date for a pick-up that would best work for you. We will try our best to suit your first choice of pick-up. Please consider we have a busy schedule and are trying our best to make this work to fit everyone's schedule.
*** Alternate date of collection:
*** Alternate time of collection:	** SELECT TIME ** 8-9am 9-10am 10-11am 11-12pm 12am-1pm 1-2pm 2-3pm 3-4pm
*** Pick up time may vary due to the traffic conditions ***
Will you provide any help with putting bags into the truck? *:	Yes No
Collection *:	Inside  Outside
Carts needed? *:	Yes No
Remarks:
IMPORTANT
* Minimum 100 bags per pick up. If collection is less than 100 bags, A&E Clothing Corp. reserves right to reschedule pick up date for more convenient time (once having another pick up in the area).*
* Minimum for CT, DE, RI, MD is 200 bags per pick up due to the greater distance. *
*Approx. count of collected bags is required to be reported to our office at # 732-396-0357 prior to arrival of our truck.*
***Please note that all clothing has to be in wearable usable condition ***
We will not pick up wet clothing.

Please read the following information before you continue. Submitting your application means you understand and agree with the following terms
READ TERMS

If You have any problem with above electronic form, please download, print and fax or email us this application: >>reservation.pdf<<