Form Center

2. First Name
3. Last Name
5. Address
   One access card per residence. Residents of single family homes and condominiums only. NO CONTRACTORS.
7. City
8. State
9. Zip Code
11. Home or Cell Phone Number
12. Email Address
14. Date Submitted
    Date Submitted
18. Terms and Conditions
    Lost card replacement fee: $10. Non-transferable, card must be returned to the Village if/when you move. I understand that the recycling center is for recycling and yard waste material generated from my property only. NO CONTRACTORS ALLOWED. I further understand that the recycling center is fully automated and secured with a camera system. If I, or someone else using my card, is caught disposing of any other material other than recycling (glass, aluminum, cardboard and paper), yard waste, scrap metal or waste motor oil my access card will be deactivated, all privileges to this facility will be lost, and I will be fined as allowed by ordinance.
20. To Complete Form*

    1. I understand the terms and conditions listed above
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22. 1. Receive an email copy of this form.
23. Email address

    This field is not part of the form submission.

24. Submit

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