Online Form - Opt in to the GO bin system

Title

First name *

Last name *

Phone *

Email *

What is your preferred method of contact? *

Phone
email

Residential address

Street Address:

City:

State:

Post Code:

Country:

Size of property in square metres *

Type of property *

Stand alone dwelling
Villa/Townhouse
Unit

Number of residents living here *

Do you have a front or back garden? *

Front
Back
Both

How did you hear about the GO bin?

Town of Victoria Park website
Advertising
Social media
Word of mouth
At an event

Any other comments