First name *

Last name *

Company name (optional)

Country / Region *Canada

Street address *

Apartment, suite, unit etc. (optional)

Town / City *

State / County * Select an option…AlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNorthwest TerritoriesNova ScotiaNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukon Territory

Postcode / ZIP *

Phone *

Email address *

Bin drop off location driveway or back lane parking spot etc *

Special Requirements (optional) (optional)

How this did you hear about Red-E-Bins (Google, Kijiji, Facebook, Printed Adds, Word of Mouth, etc.) *

Cornwall landfill will not accept black bags any longer, all bags must be clear. I agree not to put cement, sod, bricks, black bags or shingles in the bin. I also agree that I will not overfill the bin or go over the do not fill above this line. I acknowledge that over filling the bin will result in extra charges. I also agree to put junk first in the bin then any mattresses then any tires. Anything left outside of the bin will be left there. *I accept