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Customer Registration Form
"
*
" indicates required fields
Step
1
of
2
50%
Email
*
Name
*
Phone number
*
Property Information
Subject Property Address.
*
(If more than one Property please list all Above)
Number of Families
*
1-3 Families $85.00/month (Includes 2 Trash Bins and 2 Recycle Bins)
4-6 Families $120.00/month (Includes 3 Trash Bins and 2 Recycle Bins)
Multiple Properties (Quote will be sent via email)
(If more than one Property please click Above) Note* Additional Bins are $5.00/month.
Number of Trash Bins at Location
*
2 or Fewer
3
4
5
(If more than one Property please skip) Note* Additional Bins are $5.00/month.
Number of Recycle Bins at Location
*
2 or Fewer
3
4
5
(If more than one Property please skip) Note* Additional Bins are $5.00/month.
Payment Method Preference
*
Zelle/Venmo
Bank ACH
Credit Card
