Domestic Customer Registration Domestic Form Customer name * Address * Postcode * Phone number * Email Address * Number of Black Bins (General Waste) at premises? * 0 1 2 3 4 5 More Clean Cycle for Black Bins (General Waste)? * N/A 2 week cycle 4 week cycle 6 week cycle 8 week cycle 10 week cycle Ad-hoc / one-off wash Number of Blue Bins (Mixed Recycling) at premises? * 0 1 2 3 4 5 More Clean Cycle for Blue Bins (Mixed Recycling)? * N/A 2 week cycle 4 week cycle 6 week cycle 8 week cycle 10 week cycle Ad-hoc / one-off wash Number of Brown Bins (Food & Garden Waste) at premises? * 0 1 2 3 4 5 More Clean Cycle for Brown Bins (Food & Garden Waste)? * N/A 2 week cycle 4 week cycle 6 week cycle 8 week cycle 10 week cycle Ad-hoc / one-off wash Comments? If you are human, leave this field blank. Submit
