Form Center

2. First Name*
3. Last Name*
5. House Number*
6. Street Name*
8. Email Address*
10. Phone Number*
11. Phone Type
    -- Select One --CellHome

13. Participants must purchase through the city either a 12-gllon wheeled cart or a 5-gallon bucket with lid for curbside collection, no personal containers allowed! The counter-top kitchen pail is optional. If you are already a participant in the drop-off program and wish to continue to use your drop-off bucket that you already have, then check off the button "City provided drop-off bucket"

    Pick up containers at Public Works, 9217 51st Avenue, M-F 7:30 a.m. to 4:00 p.m.

    Make sure to finalize this form by checking off the agreement at the bottom, and adding your signature and date.

15. Container Selection*

    You must select one to participate.

    1. 12-gallon green cart with handle and wheels... $13.00
    2. 5-gallon bucket with gamma seal lid... $9.00
    3. City provided drop-off bucket (no charge) must already have bucket
16. Kitchen Pail

    Optional

    1. Small counter-top kitchen pail... $5.00
18. • Curbside collection is a voluntary program and residents must opt-in
    • No fee for collection, but residents must contribute 50% of cost for collection container(s) – all material must be placed in a cost-share container purchased through the city. Resident’s price for 12-gallon cart is $13.00; 5-gallon bucket is $9.00; and kitchen caddy is $5.
    • Kitchen pail is optional
    • Food scraps must be in a compostable or paper bag before placing in cart or bucket
    • Weekly collection service on Tuesdays
    • May sign up on a rolling basis and start the week after you pick up your container.
20. Agreement*

    By checking this box, you agree that you have read all the above information and agree to only use a cart or bucket purchased through the city. Participants can opt-out at any time by contacting the City's Department of Public Works. 

    Participants can pick up their containers at Public Works, 9217 51st Avenue (Monday-Friday 7:30 am - 4:00 pm)

    1. Agree
22. Signature*
23. Date
    Date

25. Once you submit this application, you will be taken to the City's store to purchase the required and optional containers. You may also purchase the containers in person at Public Works when you pick up your container. 

Leave This Blank:


27. 1. Receive an email copy of this form.
28. Email address

    This field is not part of the form submission.

29. Submit

* indicates a required field