MobileMuster - MobileMuster Expression of Interest & Registration Form


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	Help Collect Mobile Phones


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Help Collect Mobile Phones

MobileMuster Expression of Interest & Registration Form

Please indicate with a tick/s how you would like to be involved in the MobileMuster (participating in MobileMuster is free).

	Set up permanent public drop off points at your premises/retail outlet
	Run own local muster to collect mobile phones at work or in your local area (short term campaign)
	Promote MobileMuster to staff, local community and/or schools
	Other (eg. Audit rubbish bins for mobile phones)

Please provide your contact details and collection/drop off points by completing the form below:

Your contact and delivery details.

Contact name*
Organisation Name / Business name*
Shop No. or Level No.	(eg: Shop 3)
Building Name ^	(eg: Centrepoint Tower Chatswood Chase)
Street No.^	(Street Number only)
Street Name*^
Suburb*^
State*^
Postcode*^
^ these fields will be used to generate a location map.
Which local council area are you in
Phone*
Fax
Email*
Website
YesNo	Do you want this email address added to the MusterNews subscription list?
YesNo	Do you want this address listed on the mobilemuster website as a location that the public can drop off their mobile phones, batteries and accessories for recycling?

Please indicate below which of these statements best describes your business/organisation?

Mobile Phone Retailer
Mobile Phone Manufacturer
State Government Agency
Community Group

Mobile Phone Repairer
Local Council
Federal Government Agency
Other (please specify)

How did you find out about the MobileMuster Recycling Program? Please tick all boxes that apply.

Newspaper Advertising Outdoor Advertising Radio Advertising Internet Word of mouth Local Council	Telstra Account Manager Optus Account Manager Vodafone Account Manager 3 Account Manager Franchise Owner Other (please specify)
Comments

Please choose a login ID, and password. The login ID and password must be at least 6 characters in length.

Login ID *
Password *

*	I have read and agree to the terms and conditions of participation- Download - PDF terms and conditions of participation.
*	I agree to confer ownership of all mobile phones and mobile components collected for recycling to AMTA. I will not re-use or re-sell any mobile phones or mobile phones collected on behalf of MobileMuster.

Thank you for joining the MobileMuster - an officer will contact you shortly to confirm what promotional materials, bins and support we can provide to progress your involvement.

Any questions? Email mobilemuster@amta.org.au or call 02 8920 3555.

*mandatory


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