Type Full Name :
Sign With Hand
Phone #
Application Type
Donations Details
City
ZIP
Name
Certification
City
State
Required Attachments
Begin typing Bin address and select from the populated drop-down
Phone #
# of Bins Applying For
ZIP
Preferred Payment Method
Pay Later
If you need to make your payment by mail or in person, our office is located at:

1 Memorial Drive
Lodi
NJ 07644

City
Authorized Agent Details
State
Name
Tax ID #
Address
Address
On-Site Representative Details
Email
Address 2
The fee for this application is
Applicant Details
Email
Application Fee
List the name and telephone # of the person's bona fide office and, if applicable, the telephone # of the bona fide office of any other entity which may share or profit from any clothing or other donations collected via the bin.
Address
State
Business Details
Email
ZIP
List the manner in which the person anticipates any clothing or other donations collected via the bin would be used, sold, or dispersed, and the method by which the proceeds of collected donations would be allocated.
Signature
{[ADDR]}
{[CITY]}, {[STATE]} {[ZIP]}
{[APHONE]}
{[AWEBSITE]}
New Applications $100
Renewals $100
Page Title
  • Survey or Site Plan depicting where the bin would be situated
  • Written consent of the property owner to place the bin on the property
  • Proof of Charitable Non-Profit 501(c)(3) status
    • By signing below, I the owner certify that all of the information provided in this application is true and accurate.
    City
    Clothing Donation Bin Application
    Name
    State
    Phone #
    Email
    ZIP
    Bin Details
    Company Name
    In order to obtain a Clothing Donation Bin, you must provide the following documents:
    Name
    Phone #
    ZIP
    Address
    Bin Address
    Phone #
    City
    State