Trash Service Request Form
Please enter all required fields. You must submit a form by 12pm the day before trash pick-up for each individual day you require trash services. One trash service equals bringing trash bin from outside your garage door to the curb at sundown the day before pick-up and returning the trash bin to your garage door after pick-up. Service is $25.
Full Name
*
Mr.
Mrs.
Miss.
Prefix
First Name
Last Name
4 digit Membership Number
*
Contact Number
*
Please enter a valid phone number.
Email Address
*
example@example.com
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Date of requested service
*
-
Month
-
Day
Year
Date
Signature
*
Please note any special instructions. (optional)
Submit
Should be Empty: