New Customer Application

Step 1 of 8

Name*
First Last
Primary Phone*
Alternate Phone

Email
Email Consent
Please send account statements and letters via email.

Delivery Address (Vermont Only)*
Street Address Address Line 2 City State Zip
Mailing Address
Same as delivery address

Street Address Address Line 2 City State ZIP Code

Do you own or rent at this address?*

Select the fuels you require*
- Home Heating Oil (Fuel #2)
- Propane
- Kerosene
- Off-Road Diesel

Delivery Preference*
For more information about which option is right for you, visit our delivery options page.

Auto Billing Preference*
Auto billing makes it easier for you to pay your account. Each time we deliver fuel or perform a service, we'll automatically charge your credit card.

Consent*
I consent to Jackman Fuels Inc contacting me & performing a credit check.