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Refuse and Recycling Program Application


  2. TYPE OF SERVICE (check all that apply):
  3. ADDITIONAL REFUSE CART ($33 per quarter)*
  4. CURBSIDE RECYCLING PROGRAM ($13.17 per quarter/cart included)*
  5. Account will be billed quarterly beginning the first utility bill after service starts.
  6. I understand that the charges for the services requested in this application will be added to the property owner's utility bill once the application has been processed. Charges will continue to be billed until such time the property is sold or a request for cancellation of voluntary services has been submitted to the City of Rock Island. Failure to pay any of the fees associated with these programs could result in immediate termination of the voluntary service.*
  7. Leave This Blank:

  8. This field is not part of the form submission.