Section 1 of 1 in this document
Curbside Recycling Service Opt-In Form
Utility Account
Account Type
Residential
Business
City of Pocatello Account Number (including hyphen)
Customer Name (as it appears on the utility bill)
First Name
*
Last Name
*
Customer Phone Number
*
Customer Email Address
*
Service Address
Street Address
*
City
*
State
*
Zip
*
disregard this