Book Your Large Item Pick-up

Personal information entered on this form is collected under the authority of section 26(c) of the Freedom of Information and Protection of Privacy Act (FOIPPA) and will be used to contact you if needed. If you have any questions or concerns about how your information will be used, contact the City’s Records and FOIPPA Administrator at 604.927.5250 or corporateoffice@portcoquitlam.ca.

Feb 2022 - Large Item Pick-Up

First Name *

Last Name *

Please note: If you rent, homeowner permission must be provided to use the Large Item Pick-Up Program. This form cannot be submitted on a landlord's behalf — please submit your own first and last name, and have your landlord contact us via email at largeitempickup@portcoquitlam.ca or by phone at 604.927.5324 to confirm permission.

Address *

Address

City

Province

Postal Code

Phone *

Email *

Preferred method of contact?

Phone

Please pick up on this preferred (but not guaranteed) day of the week (Mon-Fri): *

Number of items to be picked up? *

Is this the first time you have used this service? *

Yes

How many of the above items selected do you have?

Small household goods – in boxes or bundled, and a reasonable size (one box or bundle is equal to one of the resident's allotted items.