New Customer Form

Service Locations

We are currently only servicing Greenville, Rensselaerville, Westerlo, and towns bordering these locations. Thank you for your support as we plan on expanding in the future.
Name*
Phone Number*
Email Address*
Physical Address*

Street Address

Street Address Line 2

CityState

Zip Code
Mailing Address (if different than physical)

Street Address

Street Address Line 2

CityState

Zip Code
Date of First Trash Pickup*

MonthDayYear
If you reside in Westerlo, Berne, Rensselaerville, or the hamlets of, please select a Tuesday pick up. If you reside in Greenville, Coxsackie, or the hamlets of, please select a Thursday pick up. Please don't hesitate to call if you have any questions.
Type of Home*
5% Military Discount (discount will be applied to your invoice)

VeteranActive DutyReserve/National GuardGold Star SpouseN/A
My Products*
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64 Gallon Trash & Recycling$39.98
tax included

Quantity

96 Gallon Trash & Recycling$42.98
tax included

Quantity

Home Pickup$10.00
Convenient at home trash pickup service. No need to bring your cans to the end of the driveway! We will take care of everything right from where you keep your cans. Price is per month.

Total $0.00
How often would you like to receive your invoice?*
Would you like a paper only invoice?*
A $2 paper billing fee will be added to each invoice if you select "Yes".
Invoices and receipts will be sent to the email provided. Automatic monthly payments may be set up during your initial payment for personal ease.

Your first invoice will be sent out one (1) week prior to your service start date. On this day you will also receive your garbage and recyling cans.
How did you hear about us?

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If a current customer referred you, who?
Service Agreement
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Service Locations