Waste Haulers Summit 2019 Grant Application

Please complete the below form to apply for the Summit. Make sure to complete the entire form and then click the blue "Continue" button. Please feel free to call Katie Sieracki at 847-423-2991 with any questions. We look forward to reviewing your application!

Event: Waste Haulers Summit 2019
First Name*
Last Name*
Your Title*
Company*
First Name on badge (if different)*
E-Mail*
Confirm E-Mail*
Work Address*
City*
State (two-letter abbreviation)*
ZIP/Postal*
Work Phone Number*
Cell Number*
Emergency Contact Person AND Phone Number*
 
To verify that you're a real human and not an automated spambot, please answer the following question:
Independence Day is the Fourth of*
 
*These fields are required to have a value.

Please tell us about your organization:

How many total vehicles are in your fleet?

What type of trucks are in your fleet? (i.e: garbage trucks, container hauling, etc.)

Tell us a little about your operations:

Do you have both residential and commercial operations?

What's currently going well with your operations?

What keeps you up at night regarding your operations?


If you could ask a room full of your peers a question or two about their operations, what questions would you ask?

If you could have dinner with a two or three others in the industry who would you choose?

Please tell us about any product acquisition plans over the next 6 to 12 months (replacements or new):

Please list at least one product or service company who you'd like to learn more about. You can enter as many as five:

What is the name and title of your immediate supervisor?

What's your shirt size?

I agree: If I am selected to attend the Summit, I agree to be present for all sessions, meetings and functions while at the event.

Please Enter a short Bio