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Inorganic
Skip Bin
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For Residential
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New Service Online Form
Thank you for choosing Rubbish Direct
Please answer the following questions to assist in providing a suitable quote for the client.
New Service Online Form
1
Client Details
2
Service Requirement
3
Status
Client Details
Do you have an account with us? Have you used us before?
(Required)
Yes
No
Client ID
What is the Address you require the services at?
(Required)
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
Country
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bonaire, Sint Eustatius and Saba
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cabo Verde
Cambodia
Cameroon
Canada
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos Islands
Colombia
Comoros
Congo
Congo, Democratic Republic of the
Cook Islands
Costa Rica
Croatia
Cuba
Curaçao
Cyprus
Czechia
Côte d'Ivoire
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Eswatini
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard Island and McDonald Islands
Holy See
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Korea, Democratic People's Republic of
Korea, Republic of
Kuwait
Kyrgyzstan
Lao People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macao
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Macedonia
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine, State of
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Romania
Russian Federation
Rwanda
Réunion
Saint Barthélemy
Saint Helena, Ascension and Tristan da Cunha
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia and the South Sandwich Islands
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen
Sweden
Switzerland
Syria Arab Republic
Taiwan
Tajikistan
Tanzania, the United Republic of
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkmenistan
Turks and Caicos Islands
Tuvalu
Türkiye
US Minor Outlying Islands
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Venezuela
Viet Nam
Virgin Islands, British
Virgin Islands, U.S.
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Åland Islands
Country
Please provide me with additional information about your address if required.
What is the name of the business or site you require the service for?
What is the best contact person?
(Required)
First
Last
Contact Number
(Required)
Email
(Required)
What type of business?
(Required)
Cafe
Restaurants
Office/Building
Apartments
Other
Please let us know what type of your business.
(Required)
Service Requirements
How soon do you require the services?
(Required)
DD slash MM slash YYYY
Where will the bins be sorted outside of the collection days?
Where will the bins be serviced from?
(Required)
Locked, Gated Area, Curbside, Etc.
Is an access device required?
(Required)
Yes
No
How far is it from the truck to where the bins are?
(Required)
Are there any time restrictions?
(Required)
We start to collect bins from 3 AM. If there are any time restrictions, please select ‘Yes’.
Yes
No
Preferred time from
(Required)
Hours
:
Minutes
AM
PM
AM/PM
Preferred time to
(Required)
Hours
:
Minutes
AM
PM
AM/PM
Is it possible to complete collections over the weekend if required?
(Required)
Yes
No
As part of our health and safty requirements can you please advise if there are any hazards on your site our driver should be aware of?
Such as Low light, Slippery floors, Stairs (how many), Steep ramps, Hidden obstacles, etc.
None
Low light
Slippery floors
Stairs (how many)
Steep ramps
Hidden obstacles
Other
How many stairs approximately?
(Required)
Please describe hazards on your site.
(Required)
Current Status
Do you currently have another contractor providing a rubbish/recycling service for you?
(Required)
Yes
No
Has your current contract expired?
(Required)
You will need to have this confirmed by requesting a copy of your contract from your current provider. Some contracts have an automatic rollover clause.
Yes
No
What type of bins do you have?
(Required)
Please describe the size and quantity of Rubbish, Recycle, Food Waste etc.
How often are they emptied per week?
(Required)
What is the reason you wish to switch to Rubbish Direct?
(Required)
I am looking for a more affordable service without sacrificing quality.
My current provider is unreliable – frequently missed collections or inconsistent pickup times.
I am dissatisfied with the customer service.
My current service does not support all of my recycling needs.
I prefer a service provider that demonstrates a stronger commitment to environmental sustainability.
Other
Do you require a site visit from a Sales Rep?
(Required)
Yes
No
Is there anything else we may need to know? Or do you have any questions?
Preferred Payment Method
(Required)
Direct Debit
Bank Transfer
Credit Card (An additional surcharge of 2.7% will be applied.)
Pay invoices by the 20th of each month to be eligible for 5% prompt payment discount.
How are you currently disposing of your Rubbish and Recycling?
Which services are you required?
(Required)
You can select multiple services.
Rubbish Collection
Recycling Collection
Inorganic Collection
Skip Bin Hire
Waste Management Planning
Other – Please contact
Do you require a site visit from a Sales Rep?
(Required)
Yes
No
Preferred Payment Method
(Required)
Direct Debit
Bank Transfer
Credit Card (An additional surcharge of 2.7% will be applied)
Pay invoices by the 20th of each month to be eligible for 5% prompt payment discount.
Is there anything else we may need to know? Or do you have any questions?
Name
This field is for validation purposes and should be left unchanged.
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