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Yard Cart Sticker Order Form
(Fields in red or with * are mandatory)

Stickers are valid from July 1st through June 30th of each year.
Pro-rated stickers can only be purchased through the Revenue Department at 747-6953.
Disclaimer
Date: 
Number of Stickers: x $50.00 (MAX PURCHASE=3)
BILLING ADDRESS The mailing address where the sticker is to be mailed.
First Name: *
Middle Initial: 
Last Name: *
Street Number: *
Street Prefix:  (e.g. N, W, S, E)
Street Name: *
Street Suffix: *  (e.g. ST, AVE, DR)
City: *  
State: 
Zip Code: *
Phone Number: *  
E-mail: 

SERVICE LOCATION ADDRESS

         The physical location of the yard cart to be picked up in the City limits.
Street Number: * (No PO Box's allowed)
Street Prefix:  (e.g. N, W, S, E)
Street Name: *
Street Suffix: *  (e.g. ST, AVE, DR)
City: *  
State: 
Zip Code: *