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Zero Waste Reusable Dishware Checkout
Organizations and individuals wishing to borrow Rural Action's plastic reusable plates, bowls, and cups should fill out this form. After filling out the form, you will receive a confirmation email.

**Your reservation has not been made until your receive a confirmation message from Zero Waste Program staff.** If you do not receive a confirmation message within 48 hours, please email Andrea Reany, andrea@ruralaction.org, or call (740) 677-4047.

All individuals and organizations outside of Rural Action are required to pay a $20 deposit prior to checking out the dishware. The entirety of this deposit shall cover any missing, damaged, dirty, or wet items. If all items that were checked out are returned in clean, dry, and undamaged condition, the $20 deposit will be returned in full. Rural Action staff will arrange payment with you upon receipt of this form.

Contact Name *
Your answer
Contact Email Address *
Your answer
Contact Phone Number *
Your answer
Organization Affiliation
Your answer
Event Name *
Your answer
What date will you pick up the dishware? *
Dishware can be picked up at the Rural Action Kuhre Center for Rural Renewal, 9030 Hocking Hills Dr., The Plains.
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What time on the above date will you pick up the dishware? *
Time
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By when will you return the dishware? *
Dishware must be cleaned and returned to the Rural Action Kuhre Center for Renewal, 9030 Hocking Hills Dr., The Plains, by close of business on the date mentioned below.
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Rural Action has a total of 100 cups, 100 bowls, and 100 plates available to loan out, which are divided into 2 sets of 50 of each item. How many sets would you like to reserve? *
Rural Action has a total of 100 cups, 100 bowls, and 100 plates available to loan out, which are divided into 2 sets of 50 cups, 50 bowls, and 50 plates.
Would you like to borrow our 3 metal wash tubs (cleaning supplies, e.g. soap and sponges, NOT included)? *
User Agreement *
I understand that, by borrowing Rural Action's reusable dishware in the amount and duration specified on this form, I agree to return every item in clean, dry, and undamaged condition by the the date specified on this form. If I do not follow these terms, I understand that my $20 deposit will not be returned to me.
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