Skip to Main Content
Do Not Show Again
Rockville City Hall will reopen to the public, Monday, Jan. 3.
Welcome to the City of Rockville Form Center. If your form requires a response, we will contact you as soon as possible.
Select a Category
Community Planning and Development Services
Housing Programs and Services
Recreation and Parks
Report a Concern
signing in or creating an account
, some fields will auto-populate with your information and your submitted forms will be saved and accessible to you.
Sign in to Save Progress
Apply for Backdoor Recycling and Refuse Service
This form has been modified since it was saved. Please review all fields before submitting.
Address or Location of Pick Up
I am requesting that the City of Rockville provide me with backdoor service, at no additional charge, for my recycling and refuse collections. I am unable to transport my carts to the curb or alleyway and there is no one in my household who is able to transport them for me.
I understand that it is necessary to reapply for this service each year. I also understand this service is based on my inability to take my recycling and refuse carts to the curb or alleyway.
Leave This Blank:
Receive an email copy of this form.
This field is not part of the form submission.
* indicates a required field
Slideshow Left Arrow
Slideshow Right Arrow