Application for Commercial Sanitation Service

Application for Commercial Sanitation Service
Date

MonthDayYear
Name of Business*
Address of Business

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Do you have a Current City of Dickson Business License?*
Name of Business Owner*
Business Owner Contact Number*

Area CodePhone Number
Business Owner Email*
How Would You Like to Receive Invoices?*
Mailing Address for Invoices

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Number of Carts Requested (Maximum of Three Carts)*
Number of Pick Up Days Requested*
Do you need cardboard removal? (Cardboard must be empty, broken down, and placed next to cart.)*
Select a Payment Option*
City of Dickson Sanitation Policy-As of January 2021
*
Should be Empty: