Name
*
First Name
Last Name
Phone
Please enter a valid phone number.
Type of Phone Number
Mobile
Home (Landline)
Office (Landline)
Email
*
example@example.com
Do you want to enroll in paperless billing?
*
Yes
No
Service (Home) Address
*
Street Address
Street Address Line 2
City
Please Select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Is your billing address the same as your service address?
*
Yes
No
Billing Address
Street Address
Street Address Line 2
City
Please Select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
GARBAGE CART
Each home is automatically registered to receive a 95-gallon garbage cart. No action is needed unless you prefer a smaller 65-gallon cart for garbage, or to utilize a personal container for garbage or for additional containers.
Garbage Cart Choices:
Would you prefer a 65-gallon (small) cart for garbage instead of the standard 95-gallon?
*
No. I’d like the standard 95-gallon garbage cart.
Yes. Please deliver a 65-gallon garbage cart.
Cost | $20.95 per month, billed by LRS to resident
Would you like an additional 95-gallon garbage cart?
*
No. I do not want an additional 95-gallon garbage cart.
Yes. Please deliver an additional 95-gallon garbage cart for $5.00 per month.
Cost | $5.00 per month, billed by LRS to resident
RECYCLING CART
Each home is automatically registered to receive a 65-gallon garbage cart. No action is needed unless you prefer to rent additional containers.
ADDITIONAL RECYCLE CART – OPTIONAL
Would you like to rent an additional 95-gallon recycle cart?
No. I do not want an additional 95-gallon recycle cart.
Yes. Please deliver an additional 95-gallon recycle cart for $5.00 per month.
Cost | $5.00 per month, billed by LRS to resident
Additional Notes/Messages
*
I have reviewed the information above and confirm that it is accurate for my waste, recycling and yard waste service needs.
SUBMIT
Should be Empty: