E-Gov Services City of Selma

Recycling

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Purpose. Use this form to request being added to our recycling pickup or for a special pickup.

* Information is required.

Contact Information

* First Name:
* Last Name:
Business Name:
Email:
* Daytime Phone:	() –
Fax:	() –
* Address:
* City:
State:
ZIP:

Issue/Problem Location

Please select the closest street number/streetname of problem location from list or select "*not on list". Provide any additional information on problem location in the box below.

* Address	- Or Other Not Listed - Invalid Address The address you entered does not match any in the system. You can select a valid address from the list, or if you are certain the address you entered is correct click the "Use the address I entered" button, to continue. The address you entered
Unit:
	Provide any additional information on location in the box below.

* Type of material.

* Type of service

Residential

Commercial

Apartment

* Amount of material

Recylcing Question or Inquiry?

Attach a Picture or File (max size: 30MB):

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* Information is required.

Notes:

If you send us a message, you will receive a Tracking Number allowing you to follow-up with your request, at your convenience.

Internal Use Only, Leave Blank:
Please leave this field blank and remove any values that have been populated for it.