413-442-1566
New Customer Application
Fields marked with a
*
are required.
First Name
*
Middle Initial
Last Name
*
Address
*
Address 2
(Optional)
City/Town
*
State
*
Massachusetts
New York
Zipcode
*
Email Address
*
Phone Number
*
+1
Tank Information
Fuel Type
*
Oil
Tank Size
*
Select One
275
(2) 275
330
(2) 330
550
1000
1000+
Tank Level
*
1/8 tank
1/4 tank
3/8 tank
1/2 tank
5/8 tank
3/4 tank
7/8 tank
full