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Please read the policy on Donation Bin Request before filling out the form below. By filling out the form you agree with the policy outlined here.

This request form is being reworked. Until it is complete, please contact Dominic L. Walker to request access to the bin.

Information she will need:

Donation Bin Request

  1. Is this a revision to a previous request? Yes/No
  2. Start Date
  3. End Date
  4. Number of Bins (1 or 2)
  5. Are you a student, faculty, or staff?
  6. Your Name
  7. Your Department and College
  8. Your email address
  9. Your phone number

HPNP Donation Identifier Sign

  1. Items Needed
  2. Organization(s) Donations will go to:
  3. Donations will be collected until (Date and time)
  4. Individual or group collecting the items:
  5. Department & College
  6. Email address for any questions


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This page was last updated Oct. 7, 2014.