Special Needs Application
Special Needs Application
Special Needs Application This form has been modified since it was saved. Please review all fields before submitting. * indicates a required field This application applies only to those households where no one is physically able to roll the garbage can to the street or have any other exceptional reasons as to why the City should provide this service. Date*Date Name* Address* Apartment/Unit # Phone* Email Name And Ages Of All Persons Living In This Household Reason Why Special Needs Garbage Collection Is Requested* Leave This Blank: Receive an email copy of this form. Email address This field is not part of the form submission. Submit Submit and Print This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.
