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Cart Registration Form

To register for a new trash cart, please use the form below. Items denoted with an asterisk(*) indicate information that must be entered on the form.

*First Name:

 

*Last Name:

 

*Address:

 

Suite or Apt.:

 

*Zip:

 

*Tel:

 

E-mail :

 

Location is a:

Residence  Small Business

Property Type:

Single   Duplex   Triplex    Fourplex

Do you:

Rent    Own  
  If you need special consideration, are elderly or disabled, please request a cart that you can handle effectively.
Check if you are disabled   


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Revised: 03/28/11.