Form for back door bin collection service

                                
                                            Back Door Bin Collection Service/Assisted Lift Request
                                        
                                            First Name:*
                                            
                                            Last Name:*
                                            
                                            Address Line 1:*
                                            
                                            Address Line 2:
                                            
                                            City or Town:*
                                            
                                            County:*
                                            
                                            Postcode:*
                                            
                                            Phone Number:*
                                            
                                            Email Address:*
                                            
                                                Does any other able-bodied person live at this address:*
                                                
Yes

No

                                            If YES explain why the occupant cannot assist with the bin?
                                            
                                            If you have a letter from medical/care professional confirming you are medically unfit to present bins at your collection point, please upload below
                                            
                                                Upload Letter
                                                
Accepted file formats include jpg, png, gif, word and pdf

                                            Please provide any additional required information:
                                            
Alternatively you can print and complete attaching doctor/healthcare professional letter and post to:

Technical Services

Civic Headquarters

Lagan Valley Island

Lisburn

BT27 4RL

Download the form

                                                Lisburn & Castlereagh City Council collects the information on this form for the purposes of providing a back door bin collection service.  The information will not be used for any other purpose and will not be disclosed to any other organisation.
Report, Pay, Apply

Back Door Bin Collection Service/Assisted Lift Request
