To order a pick-up, fill out all the fields on this form Your details Branch/Dep No * Contact name * Phone number * Email address * @bendigoadelaide.com.au Confirm email address * @bendigoadelaide.com.au Collection address Address * Suburb * State * Postcode * Please collect boxes from our office for storage Number of boxes * Additional instructions NOTE: PLEASE ENSURE YOU HAVE INVENTORIED NEW BOXES WITH ADD BOX SCREEN BEFORE ORDERING YOUR COLLECTION.