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Bulk Collection Request Form

  1. PLEASE NOTE: Bulk items are only scheduled to be picked up on Thursdays.

  2. Are you qualified for one annual low income bulk sticker? VERIFICATION OF INCOME REQUIRED below.*

  3. Please upload a photo or scanned image of a license or state identification card. This address must match the service address listed above.

  4. This can be a photo or scanned image of a bridge card, Medicaid card, or front page of a tax return that shows disability SSI.

  5. PLEASE NOTE: this request is for one (1) free item only. All other items are at bulk rates, which can be found at

  6. Refunds are not available on any bulk collection stickers. Thanks!

  7. Leave This Blank:

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