CURBSIDE RECYCLING PROGRAM OF GRAND JUNCTION SUBSCRIPTION FORM Name: _______________________________________________ Address: _______________________________________________ Zip Code: _______________ Mailing Address (If different) _______________________________________________________ Home Phone: ___________________________ Work Phone: ____________________________ BILLING (Please select from the following options, and provide additional information as needed) ____ I own/rent the residence listed above, and the City utility bill for the residence comes in my name ____ $1.75 recycling service charge will be added to your monthly utility bill. for one pick up per month ____ $3.85 recycling service charge will be added to your monthly utility bill for two pick ups per month ____ I reside at the address listed above, but my name is not on the City utility bill. (e.g., the landlord pays the utilities.) ____ Enclosed is a check for $21.00 for 12 months of service (once per month), made out to The City of Grand Junction. You may also choose this option if your City bill comes in your name, but you do not want the charge for recycling to be added to it.) ____ Enclosed is a check for $46.20 for 12 month of service (twice per month), made out to GJ CRI. ____ I own/rent the residence listed above, but utilities are not billed by the City. (e.g. townhouses) ____ Enclosed is a check for $21.00 for 12 months of service (once per month) made out to GJ CRI. ____ Enclosed is a check for $46.20 for 12 months of service (twice per month) made out to GJ CRI CONTAINERS You will need to use four containers to properly sort all material. We provide four reusable 22 gallon polypropylene bags, upon request, with initial sign up. Bins are also available for purchase. However, we do not require that you use our containers. Paper sacks, laundry baskets and boxes work well also. Please make sure that your containers: 1) are not falling apart; 2) weigh no more than 40 lbs. (with recyclables in them); and 3) do not collect rainwater, leaves, garbage, etc. ____ I would like____ 22gal. reusable recycling bags (4 are available at no charge — replacements are $3.50 each) _____ I would like____ red, open, stackable recycling bins at $12.00 each. (These are UV resistant, 18 gallon containers with the gecko logo. Dimensions are approximately 25” by 16” by 13”). If you are requesting bins please enclose a check for the proper amount made out to GJ CRI. Your containers and pick up schedule will be delivered to you upon receipt of this form. I certify that the information above is correct. I agree to participate in the curbside recycling program according to the guidelines available online. I understand that my recycling collection day(s) and set out location will be assigned and I am to have my material out by 8 a.m. for collection prior to the end of the work day. _______________________________________ Signature of Resident Date _________________________________________ Signature of Owner/Manager Date News articles, program updates and pick up schedules are available online at www.gjcri.com. Please check one of the following options: ___ I would like to receive an annual report and schedule by ground mail ___ Don’t bother! I will check your website for updates, reports and my annual schedule! * We do not follow the City’s holiday schedule. For holiday changes, please refer to the schedule on our website or the printed one we provide you. Still not sure? Give us a call! Phone: (970) 242-1036 Curbside Recycling Indefinitely, Inc. (GJ CRI) P.O. Box 2450, Grand Junction, CO 81502 Fax: (970) 243-4329 Email: [email protected] www.gjcri.com