Darien Enrollment

Name*

First NameLast Name
Phone
Please enter a valid phone number.
Type of Phone Number

MobileHome (Landline)Office (Landline)
Email*
example@example.com
Would you like to use this email for paperless quarterly invoicing?*

YesNo
Would you like to receive emails regarding services and updates?*

YesNo
Service Address*

Street Address

Street Address Line 2

CityState

Zip Code
Is your billing address the same as your service address?*

YesNo
Billing Address*

Street Address

Street Address Line 2

CityState

Zip Code
Are you 65 or older?*

YesNo
WASTE COLLECTION: What size cart would you prefer?*

35-gallon waste cart ($10.25 per month Senior Program)65-gallon waste cart ($21.48 per month)95-gallon waste cart ($21.48 per month)
RECYCLING COLLECTION: Which size recycling cart would you prefer?*

35-gallon recycling cart65-gallon recycling cart95-gallon recycling cart
All those 65 and older requesting the 35-gallon Senior Program are required to submit an LRS Senior Program Enrollment form with proof of age. Residents may find this application on our Darien webpage, at City Hall or by contacting LRS.
WASTE COLLECTION: What size cart would you prefer?*

65-gallon waste cart ($21.48 per month)95-gallon waste cart ($21.48 per month)
RECYCLING COLLECTION: Which size recycling cart would you prefer?*

65-gallon recycling cart95-gallon recycling cart
YARD WASTE CART: (OPTIONAL) Would you like a 65-gallon or 95-gallon yard waste/food scrap cart for an additional $3.08 per month?*

65-gallon yard waste cart for $3.08 per month95-gallon yard waste cart for $3.08 per monthNo thank you
ADDITIONAL CART RENTAL OPTIONS - $3.08 PER MONTH, PER CONTAINER
I would like an additional waste cart.*

65-gallon waste cart95-gallon waste cartNo, thank you
I would like additional recycling cart(s).*

65-gallon waste cart95-gallon waste cartNo, thank you
I would like additional yard waste/food waste cart.*

65-gallon yard/food waste cart95-gallon yard/food waste cartNo, thank you
Please include messages for LRS customer service.
Should be Empty:

ADDITIONAL CART RENTAL OPTIONS - $3.08 PER MONTH, PER CONTAINER