Multi Rx Prescription Plan

Please include any gate codes (if applicable)
Please tell us how you heard about us

Friendly Neighbor Google TV Facebook Flyer Event Vehicle Signage Door Hanger Other
Select Trash Collection Day

Monday Tuesday Wednesday Thursday Friday
Approximate Trash Collection Time

: Hour Minutes
Approximate Recycle Collection Time

: Hour Minutes
Select Frequency this is a 6 month service only

Once a month for 6 continuous months Once every other month for 6 months
5% Handling Fee Will Be Added To Total (Not Taxed)

My Products *

Trash Bin ONLY - Subscription ( $ 14.00 for each month.)

Recycle Bin ONLY - Subscription ( $ 14.00 for each month.)

Both Bins - Subscription ( $ 22.00 for each month.)

Three Bins ( $ 30.00 for each month.)

Four Bins ( $ 38.00 for each month.)