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PROPANE FUEL DELIVERY ACCOUNT APPLICATION

Please fill out our application form to open a propane delivery account in Nepean and the National Capital Region. A Francis Fuels representative will contact you within two business days to:

Review and confirm the information in this credit application.

Verify the availability of Francis Fuels propane delivery service to your area.

Review possible additional costs associated with rental tanks equipment installation.

For emergency fuel delivery service or for no fuel situations, please contact us directly by telephone at 613-723-4567.

APPLICANT AND PROPANE DELIVERY INFORMATION 

Please help describe your propane equipment and requirements. 

Check All That Apply*

Name*

Billing Address*

City and Province*

Postal Code*

Fuel Delivery Address (if different from billing address)

Date of Birth (yyyy/mm/dd)*

SIN

Employer's Name, Address*

Previous Home Address (if less than one year at current)

Cell or Home Phone Number*

Work Phone Number

Email

Delivery Instructions

Propane Tank Ownership*

Previous Suppliers Name or Name of Propane Equipment Installer (if applicable)

Select a Delivery Type*

Propane Tank Size

Delivery and Propane Tank Location(s)

Amount of Fuel in Tank

Propane Is or Will Be Used For

Type of Water Heater

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