Garbage Service Application Form

Town Of Rolesville Waste, Recycling, & Yard Waste Collection Service Application

Please fill out the form below, Town Staff will confirm receipt of the application through a return email to the listed address.

1. Address of Account
Street Address:
City, State, Zip:

2. Primary Email Address:

3. Housing Status:
 Own Rent

4. Name(s) to be Assigned to Account:

5. Billing Address of Account (if different than address of collection)
Street Address:
City, State, Zip:

6. Additional Email Addresses (these addresses will be used to verify service and for community notifications on upcoming events and programs):

7. Telephone Contact Information:
Home:
Work:
Cell:

8. Estimated move in date:

Note:  This information above will remain private and will not be distributed to any person, business, or vendor at any time. The Town of Rolesville ordinance requires that all homes and businesses within the corporate limits have this service through the Town of Rolesville.  There may be further confidential information required by the Town of Rolesville.  Town staff will contact you by phone and properly identify themselves when obtaining this information.  Failure to provide this information will result in a delay in waste collection services.  For questions, please contact Town Hall at 919.556.3506.