COMPLETE THE FORM BELOW FOR A REQUEST FOR SERVICE Enable JavaScript to send this form, or call (435) 503-6010. Please ensure that your garbage cans are at the curb and clear of any debris before our service is performed. We will return your garbage can(s) to the top of the driveway when completed. Contact details First name Last name Company name Contact reference (leave blank) trash can color (leave blank) Email I'd like to receive marketing emails from SuperCan, LLC. Unsubscribe at any time. Phone I agree to receive text messages from SuperCan, LLC about service updates, scheduling, and appointment reminders at the phone number provided. I agree to receive occasional marketing and promotional text messages from SuperCan, LLC at the phone number provided. Both SMS options are voluntary. Consent is not a condition of purchase. Message frequency varies. Message and data rates may apply. Reply STOP to unsubscribe or HELP for help. Privacy Policy · Terms & Conditions Address Street address Unit, apartment, suite, etc. (optional) City Select AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming State ZIP Code COLLECTION SCHEDULE What day is your garbage collected? Required Monday Tuesday Wednesday Thursday Friday Select at least one collection day. What time is your garbage collected? Required Choose an option8:00am9:00am10:00am11:00am12:00pm1:00pm2:00pm CLEANING OPTIONS How often would you like your cans cleaned? Required Monthly - $20, up to two cans cleaned, $10 per additional can Quarterly - $30, up to two cans cleaned, $10 per additional can Spring and Fall Cleaning - $75, up to two cans cleaned, $10 per additional can Single Visit - $50, up to two cans cleaned, $10 per additional can Select a cleaning option. How many cans do you need cleaned? Required 1 2 3+ Select the number of cans. ADDITIONAL INFO Where did you hear about us? Facebook/Instagram Family/Friend (Please provide name of person who referred you below) Saw us cleaning cans! Flier/Mailer Web search HOA Name of person who referred you TERMS OF SERVICE By selecting 'Yes' below you agree to the following terms: Prices listed are for a single residence and cannot be combined with neighbors. A valid credit/debit card on file is required for any of our services and will be charged upon completion of each service. Monthly and Quarterly plans are discounted and therefore require a minimum of three (3) cleanings. If the service is cancelled prior to the third cleaning a $35 stop fee will be incurred. Garbage and recycling cans are to be accessible and clear of any removable garbage or debris. Service may be denied if these requirements are not met. Required YES Please accept the terms to send the request. Upload images Share images of the work to be done0/10 Upload Images Choose or drop up to 10 images. Maximum 2 MB each, 5 MB total. Selected images are sent with your request. Send your request to SuperCan. Service is confirmed separately. Submit
