FUEL OIL ORDER FORM
 FIRST NAME  

 LAST NAME

    
 ADDRESS  

 CITY

  

STATE

  

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PHONE
 

 BILLING
PLEASE SELECT BELOW
     SPECIAL INSTRUCTIONS

I HAVE A FARMERS CO-OP ACCOUNT

I WILL LEAVE CHECK AT DOOR

I WILL PAY AT OFFICE
         
 

 PRODUCT
   PLEASE  SELECT ONE  AMOUNT

Select
Product 1  

 

  GALLONS  

 

  DOLLARS

 Select
product 2

 

  GALLONS  

 

  DOLLARS

Select
product 3

 

  GALLONS

 

  DOLLARS

Select
product 4 

 

  GALLONS  

 

  DOLLARS

Prices are subject to change without notice, as we receive product. Prices will be updated as soon as possible. We need one full day advance notice to get on the delivery schedule.