FIELDING'S OIL & PROPANE CO.

YOUR LOCAL OIL & PROPANE DEALER

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Delivery Schedule

Rochester/Somersworth

Portsmouth/Dover

Sanford/York

Biddeford/Saco

Portland/Scarborough

Bath/Brunswick

Lewiston/Auburn

Augusta/Gardiner

Waterville/Oakland

Price Protection Programs

Easy Pay Monthly Budget

Service Department

Propane Gas

Monthly Specials

New Customer Coupon

New Customer Sign Up Form

Credit Application Form

Order On-Line Form

Contact Us

         AUTOMATIC DELIVERY APPLICATION FORM

New customers please fill out the new application form below.  Once you submit the application form, one of our customer representatives will contact you to finish setting up your account.  In the form below, make sure you fill in the type of automatic customer option you would like to sign up for.  Cash Budget Option #1,    Credit Card On File Back up with 10 day credit Option # 2, Credit Card On File Option #3, (EFT) Electronic Funds Transfer Option #4, 10 Day Credit Option #5.  Or you might want to sign up for one off our Price Protection Programs.  Check programs by clicking   Price Protection Programs

House Color ?                                                            White, Blue, Green, Brown, Gray, Ect.
Fuel Type ?                                                                 Heating Oil or K-1 Kerosene
Tank Size ?                                                                 275, 330, 550, 660, 1000, Ect.
Fill Pipe Location?                                                     Facing Front Of House: Front, Left, Back, Right
Aprox. Yearly Gallon Usage ?                                 Gallons: 300, 400, 500, 600, 700, 800, 900, 1000
Driving Directions ?                                                  Cross streets, Off Major Route, Near By, Ect.
Price Protection Program?                                      Pre-Buy, Pre-Buy/Budget, Fixed Budget, None 
Type of Auto Customer?                                          Cash Budget, Electric Funds Transfer, Credit Card 

               


First Name
Middle Name
Last Name
Company Name
Billing Address
Billing Address 2
City
State
Zip Code
Delivery Address
Delivery Address 2
City 2
State 2
Zip Code 2
Daytime Phone() -
Evening Phone() -
Fax() -
E-mail Address
Color of Building
Fuel Type
Tank Size
Fill Pipe Location
Aprox. Yearly Gallon Usage
Directions
Price Protection Program
Cash Budget, Credit Card 10 Day,Credit Card, EFT, 10 Day Credit
Credit Card Type
Credit Card #
Expiration Date
3 Digit Security Code
Coupon Code ID #
 
I WOULD LIKE TO HAVE NET 10 DAY CREDIT TERMS:             CLICK HERE

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