Sign-Up Form

 
Name *
Name
Primary Phone *
Primary Phone
Secondary Phone
Secondary Phone
Direct Draft Option *
If yes, we will contact you about that information.
Service Selection *
Type the name of the person who referred you to Time Disposal.
Enter a promo code from one of our ads. By using a promo code you are agreeing to a 1 year agreement.

One Month Free Coupon!

Click the button above to open coupon. This must be printed, filled out, and mailed in to receive bill credit.

Please mail this to: 
Time Disposal 
P.O. BOX 7174 
Charlottesville, VA 22906

Referal

Dear Time Disposal Customers,

     If you were referred from an existing customer please type their name in referral box, so that they can recieve their $10 bill credit.

Thank you for doing business with Time Disposal