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2. Business Information

   Must be small, local business

4. Business Name*
5. Email Address*
7. Address*
9. City*
10. State*
11. Zip Code*
13. Phone Number*
14. Fax Number
16. Contact Person Information
18. Name*
19. Email Address*
21. Address
23. City
24. State
25. Zip Code
27. Phone Number*
28. Text notification

    1. yes
    2. no
30. Approximate Weekly Tonnage
31. Requested Start Date
33. Anticipated Materials for Collection

    1. paper
    2. cardboard
    3. mix of paper and cardboard
Leave This Blank:


35. 1. Receive an email copy of this form.
36. Email address

    This field is not part of the form submission.

37. Submit

* indicates a required field