2. Either submit the form electronically (see button at end) or mail to:
   Upper Moreland Recycling
   117 Park Avenue
   Willow Grove, PA 19090-3209
4. 1. Please tell us the Owner, Business, or Apartment name
6. Business or Apartment Name*
8. 2. Please tell us where the property is located in the Township
10. Address*
12. City*
13. State*
14. Zip Code*
16. 3. Please tell us the name of all commercial haulers picking up your recycling.
18. Hauler Number 1*
20. Hauler Number 2
22. Hauler Number 3
24. Hauler Number 4
26. Hauler Number 5
28. Business Contact Person First Name
29. Business Contact Person Last Name
31. Business Contact Person Daytime Phone
32. May we call you for additional information if needed?

    1. Yes
    2. No
34. Business Email Address
Leave This Blank:


36. 1. Receive an email copy of this form.
37. Email address

    This field is not part of the form submission.

38. Submit Submit and Print

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