Fuel Oil Online Order Form




Please fill out this short form, then scroll to the bottom to send your request and we will get back to you as soon as possible with a reply. Thank you.
*required
*First Name:
*Last Name:
Middle Init.:
*Street Address:
*City, State Zip Code:
,
city state zip code
*Email
*Phone:
Alternate Phone Number:
Account Number (if known):
If New Customer, Please Provide Directions to Home:
(Other information such as neighbors you wish to order with, changes to your house color, etc. can also be entered here.)
*What Type of Fuel Would You Like to Order: #2 HEATING OIL
KEROSENE
#2 WITH ADDITIVE
70/30 MIX
50/50 MIX
View Tank Chart  
*No specific quantity, Fill Tank:
(If YES, you may enter Quanty Requested to be "Please, fill the tank.")		 YES
NO
*Quantity Requested:
(Note: If under 150 gallons, add $0.20/gallon up charge.)
      Enter amount here.
*Are You Currently Out of Fuel?: YES
NO   Gallons currently in tank:
*Requested Delivery Date:
*Method of Payment:
(Note: All fuel must be paid for upon delivery.)		 CHECK
CASH
CREDIT CARD
*Please, find the animal below that matches the name above:
(This process helps to defeat SPAM on the Internet.)
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