Senior Service – Annual Payments

You are signing up for Lilac Disposal’s residential garbage removal.  You will be billed annually at $260.00. This price includes 1 free month ($26) for new customers.

Your specific garbage day/time and tote delivery information will be sent to you via email within 2 business days.

Terms:

$260 / year

First Name:* First Name Required

Last Name:* Last Name Required

Address Line 1:* Address Line 1 is Required

Address Line 2: Address Line 2 is not valid

City:* City is Required

Country:* Country is Required

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State/Province:* State/Province is Required

Zip/Postal Code:* Zip/Postal Code is Required

Confirm Zip Code (We only service the following zip codes):* Confirm Zip Code (We only service the following zip codes) is Required

14580145191462514526146101461814502145891445014568

Phone Number:* Phone Number is Required

DOB (FOR SENIOR SERVICE YOU MUST BE 62 YEARS OLD OR OLDER):* DOB (FOR SENIOR SERVICE YOU MUST BE 62 YEARS OLD OR OLDER) is Required

Preferred Contact:* Preferred Contact is Required

Phone Email

Number of recycling bins:* Number of recycling bins is Required

1 2 Recycling Tote

Do you rent or own?:* Do you rent or own? is Required

RentOwn

Email:* Invalid Email

Password:* Invalid Password

Password Confirmation:* Password Confirmation Doesn't Match

Password Strength

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