JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Lagos Waste Collection
This form has been created by the Revival and Resurrection brand (@rrcollective_) for the sole purpose of adding participants to our voluntary waste collection database and empowering Lagos, Nigeria residents to enhance sustainability in their personal climates. We will pick it up from you!!
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Email
*
Your email
Full Name
*
Your answer
Age
*
Your answer
Contact number
*
Your answer
Full Address (Please include a Landmark)
*
Your answer
I am a Lagos, Nigeria resident that would like a free, sustainable, custom Revival and Resurrection waste collection bag to help me store my solid plastic waste for regular waste collections.
Yes
No
Clear selection
I would like to opt-in or opt-out of the Revival and Resurrection points system. The Revival and Resurrection points system will award points in exchange for waste collections that accumulate to a variety of rewards as advertised on our website.
Opt-in
Opt-out
Clear selection
By filling out this form you are agreeing to the Revival and Resurrection brand's "Policies" and "Terms and Conditions."
Agree
Disagree
Clear selection
By filling out this form you are opting in, to allow for the Revival and Resurrection Brand to use the above data to organise regular waste collections from your given location.
I understand
I do not understand this
Clear selection
Would you like for your email address to be added to our subscription list?
Yes
No
Clear selection
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Revival Resurrection.
Report Abuse
Forms
