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New Customer Enrollment Form Fountain Hills

Enrollment Form
 
 Customer Name: Email:
 Service Address:    
 Billing Address (if different)    
 Daytime Phone: Evening Phone
 Requested Delivery Date:    
 Vacation Hold Stop Date: Restart Date:
       
SELECT 1 OPTION TRASH (TAN LID) RECYCLE (BLUE LID) MONTHLY RATE*
Option 1 1 x per week 1 x per week $11.44
Option 2 1 x per week (2 cans) 1 x per week $16.44
Option 3 2 x per week ** 1 x per week $16.44
Option 4 2 x per week ** 0 $16.44
           
         
YES NO YARD WASTE (GREEN LID)     OPTIONAL COST*
Add Yard Waste Service 1 x per week 95 gallon only $15.00 + monthly rate
           
* Above rates reflect monthly amounts but are billed on a quarterly basis
** Potentially your service days will be only one day apart for additional trash service
 
Please check appropriate container size
Trash: 95 gallon 65 gallon
Recycle: 95 gallon 65 gallon

  

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4811 W Lower Buckeye Rd, Phoenix, Arizona - (602) 237-2078