Drop Off Facility Gate Card

2. Village of Thiensville Yard Waste Facility Card Application

   Village of Thiensville Yard Waste Facility Card Application

4. Card Type*

   1. New $20
   2. Annual Renewal $15
   3. Lost Card Replacement $10

5. Date*
   Date

7. First Name*

8. Last Name*

10. Phone*

11. Email

13. Address1*

15. City*

16. State

17. Zip

19. Upload Proof of Residence*

20. Document Type

    1. Driver's License
    2. Utility bill
    3. Mortgage Statement
    4. Tax Bill

22. After form submission you will be directed to the credit card processing page. Once the form and payment are received a new gate card will be mailed to you

    After form submission you will be directed to the credit card processing page. Once the form and payment are received a new gate card will be mailed to you

24. For Village Use Only: Assigned Card Number _____________ Date Activated _____________

    For Village Use Only: Assigned Card Number _____________ Date Activated _____________

Leave This Blank:


26. 1. Receive an email copy of this form.
27. Email address

    This field is not part of the form submission.

28. Submit Submit and Print

* indicates a required field