Contact Us Never worry about heating your home again with an experienced team you can lean on like family. New Customer First Name Middle Name Last Name Suffix Cell Phone Number Home Phone Number Billing Address City State / Province Postal / Zip Code Is your Delivery Address the same as your Billing Address? Yes No (please add below) Delivery Address City State / Province Postal / Zip Code Email Residence Information Own Rent Landlord Heating System Heat Only Heat & Hot Water Unsure Alternate Heat Sources (if you have an alternate heat source, you must be a Will Call customer unless otherwise approved by Manager) Heatpump Wood Stove Gas Fireplace No Other Heat Source Delivery Method Preference Automatic Will Call Above Ground or Under Ground Above Below Tank Size 33 lb (must have multiple tanks) 100 lb 120 lb 120 gal 250 gal 320 gal 500 gal 1000 gal Are you a senior citizen (65+)? Yes No Delivery Information Last two (2) dates of deliveries and number of gallons delivered (complete this section ONLY if you are signing up for Automatic Delivery) Additional Comments Applicant’s Electronic Signature (type name) Submit Tank Install or Replacement First Name Last Name Email Cell Phone Number How did you hear about us? Message Submit Report a Problem First Name Last Name Email Cell Phone Number How did you hear about us? Message Submit General Inquiry First Name Last Name Email Cell Phone Number How did you hear about us? Message Submit New Customer First Name Middle Name Last Name Suffix Cell Phone Number Home Phone Number Billing Address City State / Province Postal / Zip Code Is your Delivery Address the same as your Billing Address? Yes No (please add below) Delivery Address City State / Province Postal / Zip Code Email Residence Information Own Rent Landlord Heating System Heat Only Heat & Hot Water Unsure Alternate Heat Sources (if you have an alternate heat source, you must be a Will Call customer unless otherwise approved by Manager) Heatpump Wood Stove Gas Fireplace No Other Heat Source Delivery Method Preference Automatic Will Call Above Ground or Under Ground Above Below Tank Size 33 lb (must have multiple tanks) 100 lb 120 lb 120 gal 250 gal 320 gal 500 gal 1000 gal Are you a senior citizen (65+)? Yes No Delivery Information Last two (2) dates of deliveries and number of gallons delivered (complete this section ONLY if you are signing up for Automatic Delivery) Additional Comments Applicant’s Electronic Signature (type name) Submit Tank Install or Replacement First Name Last Name Email Cell Phone Number How did you hear about us? Message Submit Report a Problem First Name Last Name Email Cell Phone Number How did you hear about us? Message Submit General Inquiry First Name Last Name Email Cell Phone Number How did you hear about us? Message Submit Never worry about heating your home again with an experienced team you can lean on like family.
