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Garbage Districts Participation Form
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First Name:
*
Last Name:
*
Email Address:
*
Are you interested in participating in a garbage district:
*
I am interested
I am not interested
I would like my waste bin collected:
*
once per week
once every other week
other
If you choose other in the previous question, how often would you like your waste bin collected:
I would like my recycle bin collected:
*
once per week
once every other week
other
If you choose other in the previous question, how often would you like your recycle bin collected:
I would like to see the following discounts:
for seniors
for veterans
for annual pre-payment
other
If you choose other in the previous question, please explain here:
Supervisor's Office
Supervisor's Office Home
State of the Town Address
Contact Information
475 Calkins Road
Rochester, NY 14623
(585) 334-7700
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