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Immaculate Bins
Trash Bin Cleaning
Immaculate Bins
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Customer Intake Form
Thank you for your interest in Immaculate Bins! Please enter your information below to get started. Once submitted, you will receive an email confirming your upcoming appointment. Your credit card will be processed after each cleaning based on your service plan. Feel free to call or text us directly as well at
618-680-0159
or email at
Info@immaculatebins.com
.
First name
Last name
Email
Company
Phone
Street Address
City
Region/State/Province
Postal / Zip code
Bin Cleaning Scheduling Info Below!
How Many Trash / Recycle Bins Need Cleaned?
*
1 Bin
2 Bins
3 Bins
4+ Bins. Please explain in 'More Information' section
Desired Cleaning Frequency for Trash / Recycle Bins?
*
Monthly Service - $15 for first bin, $29.95 for to 2 bins ; $5 each additional
Quarterly Service - $18 for first bin, $34.95 for 2 bins ; $5 each additional
On Demand Service - $22 for for first bin ; $10.00 each additional
What Day Are Your Bins Emptied By Your Waste Company?
Approximately What Time Is EACH Bin Emptied By Your Waste Company?
What Neighborhood or Subdivision Do You Live In? (optional)
Gate Code? (If Applicable) (optional)
Do You Have A Promo Code? (optional)
Do You Need A Quote On Pressure Washing Services As Well? (optional)
Driveway/Patio
Sidewalk
Commercial Dumpster
Other (please explain below)
How did you hear about Immaculate Bins?
*
Social Media
Google (or other search engine)
Friend or Neighbor
Print Advertisement
I saw your truck!
Other
More Information? Please explain below. (optional)
Submit & Select Pricing Plan
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