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* Indicates required question
Client Name
*
Your answer
Property Address
*
Your answer
I am registering for :
*
In Season Only Trash Assistance Services - One Payment of $375
In Season Only Trash Assistance Services - $80 / month May-Sept
Year Round Trash Assistance Services - One Payment of $750
Year Round Trash Assistance Services - $70 / month for 12 months
What is the name and phone number of your trash service company?
*
Your answer
Scheduled pick ups per week
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1
2
I have more than 2 scheduled pick ups in a 7 day period
My TRASH pick up days are (Day the truck arrives)
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Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
Required
Recycling is picked up:
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Your answer
Does your trash service serve on Holidays?
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Yes
No, holiday pick ups are adjusted
Please tell us where your bin storage location is. (The place to bring the bins to after pick up)
*
Your answer
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