Your Name (required)

    Your Email (required)

    Contact Phone (required)

    Address (required)

    Suburb (required)

    Please tick one of the following 3 options:

    Previous Address (required)

    Suburb (required)

    New Address where bins are to be transferred to: (required)

    Suburb (required)

    Retrieval Date:

    Please arrange a retrieval of the following bins - tick appropriate box:

    Number of Food and Garden Organics Bins (required)

    Number of Recycle Bins (required)

    Number of General Waste Bins (required)

    Additional information/comments: