Trash & Recycle Cart Order Form

Trash & Recycle Cart Order Form
Please choose which size you would like delivered to your home.
Trash

95 Gallon Trash Cart95 Gallon Recycle Cart
-or Recycle

65 Gallon Trash Cart65 Gallon Recycle Cart
I would like an additional Trash Cart65 gallon95 gallon
I would like an additional Recycle Cart65 gallon95 gallon
Name
Phone
Address
Lot #
Email
example@example.com
Date

MonthDayYear
Date
COMMENTS
RETIRED CAN NUMBER/S
19303 Schmarr Drive, Lawrenceburg, IN 47025 (812)537-3091 * Fax: (812) 537-1521 www.hiddenvalleylakeindiana.com
Should be Empty: