2. 
4. Thank you for shopping at the Reuse Store!
   Please fill out the checkout form below.
6. Name*
8. Email address*
10. Pounds of material diverted from the landfill*

    What was the TOTAL weight of your materials (including the cart, if applicable) today?

12. Cart*
    -- Select One --ABCDEFGHIJKLMNONONE

    Choose the letter listed on your cart.  If you had no cart choose 'NONE'.

14. Of which of the following eligible groups are you a member?*

    1. Artist
    2. Nonprofit
    3. Student
    4. Religious organization
    5. Daycare facility
    6. Camp or after school program
    7. Hospital
    8. Social worker
    9. ACC government
    10. Other
16. Name of your organization ("self" if applicable)*
18. Which COUNTY do you live or work in?*
    -- Select One --ClarkeBarrowJacksonMadisonOconneOglethorpeHallWaltonGwinnettDawsonNewtonFultonGreeneHartEffinghamOther - please list below
20. County if 'Other'

    If your county was not listed above, please write in your county (and state if other than GA).

22. What items did you get today? (include approximate quantities)*
24. What items do you most need/want from the Teacher Reuse Store?
26. Is this your first visit to the store?*

    1. Yes
    2. No
28. How did you hear about us?
30. Any other feedback?
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32. 1. Receive an email copy of this form.
33. Email address

    This field is not part of the form submission.

34. Submit

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