Curbside Pickup Order Form Step 1 of 7 14% Choose Disposal ItemsAppliance Disposal List Appliance Quantity Subtotal Actions Edit Delete There are no Appliances. Add Appliance Maximum number of appliances reached. Furniture Disposal List Furniture Quantity Subtotal Actions Edit Delete There are no Pieces Added. Add Furniture Maximum number of pieces added reached. Electronics Disposal List Electronics Quantity Subtotal Actions Edit Delete There are no Devices Added. Add Device Maximum number of devices added reached. Lawn / Garden / Tool Disposal List Equipment Quantity Subtotal Actions Edit Delete There are no Items Added. Add Equipment Maximum number of items added reached. Shipping Mailing Material Disposal List Shipping/Mailing Materials Quantity Subtotal Actions Edit Delete There are no Recyclable Materials. Add material Maximum number of recyclable materials reached. Sport / Outdoor Equipment Disposal List Sport/Outdoor Quantity Subtotal Actions Edit Delete There are no Items Added. Add Equipment Maximum number of items added reached. Total Disposal Cost ($): Estimate The Pick Up FeesSelect the Service ZIP code*This is the delivery service address zip code where the items needs to be picked up fromZIP codes53001 Adell53011 Cascade53013 Cedar Grove53015 Cleveland53020 Elkhart Lake53023 Glenbeulah53040 Kewaskum53044 Kohler53070 Oostburg53073 Plymouth53075 Random Lake53079 St Cloud53081 Sheboygan53083 Sheboygan53085 Sheboygan Fall53093 WaldoPickup Cost Based on your locationSubtotal $0.00 Pickup Tax $0.00 TotalDisposal Cost From page 1.Subtotal Price: $0.00 Disposal Tax $0.00 TotalTotal Service CostSubtotal $0.00 TaxTotal Service Address / Pick Up LocationAddress* Street Address Address Line 2 City Service Address StateAlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Name* First Last Email* Phone* This field is hidden when viewing the formBooking ServiceSelect the Drop-off Time and Day Select Pickup Date December 2024 Sun Mon Tue Wed Thu Fri Sat 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Using the calendar, select available date for pickup that works best for you and proceed to the next step. Make sure to have all the scheduled disposable items on the selected date by 8 AM. It will be picked up that day sometime during business hours. Service Address / Pickup Location ContinuedIs the Billing Address same as Service Address?* Yes No Billing Address Street Address Address Line 2 City Billing Address StateAlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Special InstructionsTerms and Conditions* By checking the box and By signing below, you are agreeing and accenting to all of the Curbside Pick-Up terms & conditions. Signature* {all_fields} Subtotal $0.00 Coupon Sales Tax ($)Total $0.00 Payment DetailsSelect Payment Debit / Credit or PayPalCredit CardPayPal Checkout American ExpressDiscoverMasterCardVisaMaestroSupported Credit Cards: American Express, Discover, MasterCard, Visa, Maestro Card Number Expiration Date Security Code Cardholder Name