Disposal request

Email:

email of the customer

First name:

first name of the customer

Last name:

last name of the customer

Phone number:

Enter phone number in the international format, e.g., +490123456789

Date of disposal:

date of disposal in format YYYY-MM-DD HH:MM (e.g. 2024-01-01 13:00)

Address:

address of the customer

For a more accurate address, adjust the position on the map with a marker.

Additional notes:

additional notes for the order

Use bonus points:

Use bonus points

Discount:

Discount in percentage