Begin Service Name: * First Last Name: * Last Address: * City: * Zip: * Phone (all numbers, no dashes or spaces): * Email: * (VERY IMPORTANT: please provide one that you check regularly) Pickup Day Preference: * Monday Thursday Friday Pickup Location: * End of Driveway - Free! Garage/Front Door - $2.50/pickup (drive must be plowed during winter months) Special Instructions (color of shed, near wood pile, etc...): Plan Choice: * Plan A - Weekly Service Plan A - Every-Other-Week Service Plan B - Weekly Service Plan B - Every-Other-Week Service Plan C - Weekly Service Plan D - Commercial Customers (contact office) Plan E - Recycling Only Useable Compost I would like compost during the summer months Start Date (mm/dd/yyyy): (the quarterly payment will be due before service begins). * Click the entry box to see a calendar and select your start date. Note: on some browsers the calendar does not show - just enter the date manually. Referred By: How did you hear of Keep Magnolia Clean, LLC? Referral/Neighbor Goggle/Internet Search Town of Nederland Website Magnolia News listserv Nedheads Facebook page Ned Mammas listserv Sugarloaf E-newsletter Keep Magnolia Clean literature Other: Specify Other Please Payment Choices - payment is confirmation of terms and conditions * Check (KMC preference) PayPal To avoid SPAM, we are required to use the method below.