SPECIAL PICK UP

Please fill out the form completely. A customer service representative will
contact you to confirm the price, date, and time of your special pick up.

Thank you for choosing AAA!

Are you a current AAA customer? Yes No

Special pick up for: Commercial Residential

Billing Information

Company:

Mr. Mrs. Ms.

Name:     

Address:  

City:          State: Zip:

Home Phone: - Work Phone:

Email:    

IS THE PICK UP ADDRESS THE SAME AS THE BILLING ADDRESS?
IF "NO", PLEASE FILL OUT THE ADDRESS FORM BELOW.

Pick Up Information

Address:

City: State: Zip:

LIST EACH ITEM FOR PICK UP: :

COMMENTS:

Professional Service with a Personal Touch Since 1972
AAA Recycling and Trash Removal Services
4619 West Ox Road, Fairfax, VA 22030
(703) 818-8222 or Fax (703) 803-1379