Name
*
First Name
Last Name
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email
*
example@example.com
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Preferred Communication Method:
*
Text
Email
Service Selection:
*
7 gallon, bi-weekly collection $22/month
7 gallon, weekly collection $32/month
35 gallon, bi-weekly collection $54/month
Service Agreement
By completing and signing this form, you agree to enroll in curbside compost collection services based on the selected bin size and collection frequency, and agree to the associated monthly payment.
Signature
*
Payment Selection
Payment Selection
Should be Empty: