New Customer Request Form

If you would like to start service with PFI Rubbish, please fill out the form below.
Our office staff will call you to verify your information before service begins.
PFI Rubbish Service, Inc.
74-5599 Pawai Place
Kailua-Kona, Hawaii 96740

Phone (808) 329-3440
Fax (808) 329-5507
You will be contacted within 48 hours.

Problems with this form? Please contact the Site Administrator
First Name:
Last Name:
Phone Number:
E-Mail Address:
Service Address:
(Please add a brief
description, if needed)
Special Instructions:
(Optional - Beware of
dog, cans in wall, etc.)
Billing Address:
Billing City, State, Zip:
How often to you want
service? (Check one)
How often do you
want to be billed?
Did you have service
with us before?
How did you hear
about PFI Rubbish?