Online Order Form
Minimum order 125 gallons!
Account Information
*
Account #:
Please call the office if you do not know your Account Number before trying to initially place an online order!
*
Name on Account:
Full Name on Account (i.e. John Smith)
*
Delivery Address:
*
City:
*State:
*Zip:
Do not use spaces or dashes
*
Phone #:
Please enter a Daytime or Work Phone Number.
*Email Address:
Payment Information
Payment Type:
CreditCard - Visa
CreditCard - Mastercard
CreditCard - Discover
Cash
Check
Money Order
Please fill in Location Details!
Please provide description of payment location if not paying by Credit Card.
Order Information
*Requested Delivery Date:
Requested date must be Monday - Friday.
Next 2 WORK Days
Next 3 WORK Days
Orders received after 9:00 A.M. will not be delivered until at least the following day, except on Friday, then delivery will not be until the following Monday.
Need same day delivery? Please call:
(570) 546-2746
*
Amount of Heating Oil
Enter estimated gallons to be delivered
Special Instructions
(if any)
Please completely fill out this form before hitting submit
