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2. Contact Information
4. First Name*
5. Last Name*
7. Address*
9. Phone Number*
10. Email Address*
12. Is this a move-out cleaning?*

    1. Yes
    2. No
13. Move-out date (if yes)
    Move-out date (if yes)
15. Please describe the items to be collected.*
17. Disclaimer

    Requests submitted via this form will be reviewed and a customer service representative will reach out to you to schedule the pickup.  If you have any questions about fees or regarding what can be disposed, please reach out to our team at 847-716-3568.

    Please note, the Village does not accept yard waste as a special collection.

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19. 1. Receive an email copy of this form.
20. Email address

    This field is not part of the form submission.

21. Submit

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