Service Sign Up Form

Cleaning Service

Name *

First

Last

Email *

Cell Phone (For Text Messaging) *

Address *

City *

ZIP Code *

Select Your Service Plan *

Monthly 1-2 Bins -- $35/Month
Monthly 3+ Bins -- $10/Month For Each Additional Bin
Quarterly 1-2 Bins -- $45/Quarter
Quarterly 3+ Bins -- $15 For Each Additional Bin
One-Time Special Cleaning -- $75 for a one time service of 1 trash bin and 1 recycle bin. Each additional bin is $25

Please Check The Box

Neighborhood Subdivision ( If Applicable ) *

Who Is Your Trash Company? *

What Is Your Trash Pickup Day? *

If Charmeck is your hauler, please indicate if you are on either the green OR the orange schedule. Please Indicate *

What Is The Next Date Recycling Is Picked Up? *

Is Your Recycling Weekly or Bi-Weekly? *

How Many Of Your Bins Are TRASH Bins? *

How Many Of Your Bins Are RECYCLING Bins? *

Where Did You Hear About Us? *

If Other - Please Specify

Additional Notes & Instructions