DeCamp Trucking

Your Choice Disposal Company

1-888-666-5920

425 Washington St., #192
Claremont, NH 03743
info@decamptrucking.com

New Customers

New Service Request

First Name:

Last Name:

Company (If applicable):

Street: (Service Address)

Apartment, Suite, Building:

City:

State/Province:

ZIP/Postal Code:

If billing address is different from service address, please specify in comments/addtional information section.

Email:

Cellular Phone:

Home Phone:

Business Phone:

Start Service Date:

Your new customer packet will include your actual pickup start date.

*Service Requested:

*Frequency of Pickup:

Do you want to rent a container: ($3/month fee)

Yes No

*Container Size:

Type of Service:

*Comments/Additional Information:

*Billing Option:

Invoice By Mail eStatement PrePay Plan Other: (Specify in Comments)

How did you hear about DeCamp Trucking?

Were you referred by someone and if so please enter their name:

Submit Your Request:

425 Washington St., #192
Claremont, NH 03743
info@decamptrucking.com