Name *

First Name

Last Name

Phone

(###)

###

####

How interested are you in participating in a pilot program for food waste collection? *

On a scale of 1-5, 1 = least interested, 5 = most interested

1 (not at all interested)

2 (not very interested)

3 (neutral)

4 (somewhat interested)

5 (very interested)

What type of collection service would you be most interested in? *

Weekly Residential Curbside Pickup

24/7 Community Drop Off Site

Workplace Drop Off Site

Other (Please specify)

None

What is a price you'd be willing to pay for the selected service?

(Be honest! No wrong answers here!)

$0

$1-$10/month

$11-$20/month

$21-$30/month

$31-$40/month

Other (Please specify)