* required

Your First Name*:

Your Last Name*:

Second Household Member:

Phone Number*:

Alternative Phone Number:

Email*:

Please Select Your Township*:
Please Select...BarrettChestnuthillCoolbaughDelaware Water GapE. Stroudsburg BoroughEldredHamiltonJacksonMiddle SmithfieldMt. PoconoParadisePoconoPolkPriceRossSmithfieldStroudStroudsburg BoroughTobyhannaTunkhannockOther

If "Other", County and Township:

Mailing Address*: This is the address your permit tag will be mailed to.

City:

State:

Zip:

Property Address*: This may be the same as your mailing address.

City:

State:

Zip:

Home OwnerRenter

Garbage Company (company who collects your weekly garbage)*:

Driver's License Number(#)*:

State*:

Please select your drop off location*:

Military RoadDCNR Route 611Military/DCNR

-All information given will NOT be distributed and will be used by only The Waste Authority for recycling location registration purposes.

-Your registration will be mailed to the given address, please allow 3 to 5 business days for request to be processed.

RELEASE:
I understand bringing my recyclables to the Monroe County Waste Authority recycling sites is optional and can be a service through my waste hauler. I hereby release the Monroe County Waste Management Authority from any liability associated with any risks involved when voluntarily recycling on site. I have reviewed and read the rules and regulations as a prerequisite to registering for the recycling permit. All information given will NOT be distributed and will be used ONLY by the Waste Authority for recycling location registration purposes and added to the mailing lists for updates.

I understand*