Owner First Name *
Owner Last Name *
Address *
Address 2
City *
State *
Zip Code *
Email *
Mobile Number *
SMS Notifications *
Yes
No
I am a Senior Citizen (65+) *
Yes
No
Property Type *
Primary Residence
Second Home
Vacation Rental
Commercial
Other
PROMO CODE
Day(s) TRASH is Collected
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
Time TRASH is Collected
Early Morning (before 9am)
Mid Morning (9am-11am)
Late Morning (after 11am)
Other
Can location
Front of House
Back of House
Left Side House
Right Side House
Garage
Driveway
Shed
Other
Permission to Brand TRASH Cans
Yes
No
Day(s) RECYCLABLES are Collected
NONE
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
Time RECYCLABLES are Collected
Early Morning (before 9am)
Mid Morning (9am-11am)
Late Morning (after 11am)
Other
Can location
Front of House
Back of House
Garage
Driveway
Other
Permission to Brand RECYCLE Cans
Yes
No
Gate Entry Code
Garage Entry Code
Lock Combination
Other
Pick a Plan
PLAN-1 - $29/month, 1 TRASH collection per week, 2 cans max.
PLAN-2 - $49/month, 2 TRASH collections per week, 2 cans max.
PLAN-3 - $64/month, 1 TRASH & 1 RECYCLE collection per week, Up to 4 Cans
PLAN-4 - $96/month, 2 TRASH & 1 RECYCLE collection per week, Up to 6 Cans
Terms and Conditions
I have read and accept the Terms and Conditions.
Purchase Redirect
After submiiting your completed form you will be redirected to where you can select the desired plan to purchase. SENIORS ENTER PROMO CODE "LYCSENIOR10" FOR YOUR 10% DISCOUNT.
SUBMIT
TERMS AND CONDITIONS
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