Assisted Pickup

ASSISTED PICKUP

As a courtesy to residents, the Village provides assisted pick up to those who are physically unable to place their garbage, yard debris, or recycling curbside. Each request is independently reviewed and Public Services staff schedule a site visit to evaluate the request. Residents are required to complete an application form, which can be completed electronically below or over the phone in just a few minutes. For more information or for a copy of the form, please contact the Public Services Department at (910) 295-5021.

Date:
Name:*
Email:
Phone:(XXX-XXX-XXXX)*
Address:*
City:*
State:*	Zip:*
Please describe your hardship:*
Is the hardship a permanent situation?* YesNo
If not a permanent hardship, what is the length of time you need back door service? Ex. 10 Weeks
By filling out and signing this application, you are giving the Sanitation Division of the Public Services Department permission to enter your private property to collect household garbage and recycling. It is understood the Public Services Department will not be responsible for any damage to property which may occur as a result of collecting garbage and recycling on private property. All garbage and recycling must meet Village standards before it will be picked up.
Where will your garbage and recycling be located? (The collecting point must be such to allow quick and easy access by the Village staff)
Submit
* Required