Form

B.I.R.M. Residential/Business Trash Pick-Up Form

Sign up to apply for Block Island Recycling Management's residential and business trash and recyclable pick-up
Name*

First NameLast Name
Email*
example@example.com
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Street Name*
House Fire Number*
Location of House and Trash/Recyclables*
Please provide an accurate description of location of the house where service is to be provided and location of trash/recyclables to be picked up.
You can schedule a one-time pickup for any day of the week for $55. Please choose the date you would like a pick-up from the calendar below.
Date

MonthDayYear
Please choose the date you would like to have your trash and recyclables picked up
Our seasonal pick-up service begins on June 1 and ends September 15. Pick-ups are twice per week and is $650 for the season. You can add months before or after for $100/month. Pre- and post-season pickup is once per week on the weekend day of the pick-up schedule you choose below.

Please also select "seasonal pick-up contract" in the products section below.
Monday and FridayTuesday and SaturdayWednesday and SundayDoesn't apply to me
Realtor handling Rental
Months to Add Prior to June
If you would like pick-up service prior to the June 1 start, please choose the number of months required.
Months to Add After September
If you would like pick-up service after September 15 end, please choose the number of months required.
A yearly pick-up contract is billed monthly at $100/month for a total of $1,200.00 for the year. Pick-ups are once a week on Wednesdays. We will contact you to begin your pick-up schedule once we receive your application.

Please select "yearly pick-up contract" below (plus any additional months you'd like)
My Products*
prevnext( X )
YEARLY PICK-UP CONTRACT
A yearly pick-up contract is billed monthly at $100/month for a total of $1200.00 for the year. Pick-ups are once a week on Wednesdays. We will contact you to begin your pick-up schedule once we receive your application.

$1,200.00



SEASONAL PICK-UP CONTRACT
Our seasonal pick-up service begins on June 1 and ends September 15. Pick-ups are twice per week and is $650 for the season. You can add months before or after for $100/month. Pre- and post-season pickup is once per week on the weekend day of the pick-up schedule you choose below.

$650.00



January (optional addition)
Add this month on top of your Seasonal Pick-Up Contract

$100.00



February (optional addition)
Add this month on top of your Seasonal Pick-Up Contract

$100.00



March (optional addition)
Add this month on top of your Seasonal Pick-Up Contract

$100.00



April (optional addition)
Add this month on top of your Seasonal Pick-Up Contract

$100.00



May (optional addition)
Add this month on top of your Seasonal Pick-Up Contract

$100.00



October (optional addition)
Add this month on top of your Seasonal Pick-Up Contract

$100.00



November (optional addition)
Add this month on top of your Seasonal Pick-Up Contract

$100.00



December (optional addition)
Add this month on top of your Seasonal Pick-Up Contract

$100.00



ONE-TIME PICK-UP CONTRACT
You can schedule a one-time pickup for any day of the week for $55.

$55.00



Total

$0.00

Payment Methods

Debit or Credit Card

Choose from one of the PayPal options to make your payment.

Should be Empty:

B.I.R.M. Residential/Business Trash Pick-Up Form

You can schedule a one-time pickup for any day of the week for $55. Please choose the date you would like a pick-up from the calendar below.