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2. Request for TV/Monitor Pick-Up

4. The Village of Pelham Department of Public Works collects TV and computer monitors on the last Friday (excluding Holiday weeks) of every month by appointment only. They must be left curbside (for multi-family dwellings, the place near where your garbage is normally deposited) no earlier than the evening prior to 7:00 p.m. to the collection and no later than 7:00 a.m. the day of pick-up. 

   Please note, the screen must be protected with heavy-duty tape and placed in an X over the screen.

   Please complete the form below to schedule a TV monitor pick-up. 

   A reminder will be sent the week of pick-up.

   
   

   
   

6. Full Name
8. First Name*
9. Last Name*
11. Full Address
13. Address*
15. City

    Pelham

16. State

    NY

17. Zip Code

    10803

19. Phone Number*
20. Email Address*
22. Number of TV Monitor/s*
    -- Select One --0123+
23. Number of Computer Monitor/s*
    -- Select One --0123+
Leave This Blank:


25. 1. Receive an email copy of this form.
26. Email address

    This field is not part of the form submission.

27. Submit

* indicates a required field