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Welcome to the Comdisco equipment return form.

Fields marked with an * are required

First Name:* Last Name:*
Company:* Title:
Address 1:*
Address 2:
City:* State:* Zip Code:*
Phone No:* Fax No.
Email Address:*
Pick-up Location
Address:*
Suite or Floor: 
City:*
State:* Zip Code:*
Site Contact 1
Name:*
Phone:* Pager/Cell: 
Site Contact 2
Name:
Phone:  Pager/Cell: 

Contract Number*:   (i.e. 01-SL12345-00)
Equipment available on: 
Hours Available:   to 
Can this location accept a semi?   Yes     No
Dock?   Yes     No

Qty* Device Type* Manufacturer* Model* Processor Speed/ Monitor Size

Comments:
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