2. 
3. City of Newnan/Amwaste Additional Services

   This form only needs to be filled if you are in need of backdoor service or if you need a second trash cart.

   ONLY RESIDENTIAL PROPERTY OWNERS NEED TO FILL OUT THIS FORM.

5. First Name
6. Last Name
8. Property Address
10. City
11. State
12. Zip Code
14. Phone Number*
16. Email Address*
18. Billing Address (if different than Property Address)
20. City
21. State
22. Zip Code
24. Services Requested

    1. Medical Backdoor - $32.40 per month (Doctors note required)
    2. Premium Backdoor - $48.75 per month
    3. Additional Cart - $5.00 per month
26. Upload Doctors Note (If Required)
Leave This Blank:


28. Submit

* indicates a required field