Guardian Fuel & Energy Customer Application

Fill out the application below or give us a call to become part of the Guardian Fuel & Energy family.

Applicant Name*

SS Number

Phone*

E-mail

Delivery Address*

City

State

Zip

Check if Address is The Same For Billing

Billing Address

City

State

Zip

Delivery Remarks

Special Instructions

Can Driver park in the driveway if fill pipe is less than 125 from the street?
YesNo

How did you hear about us?

How is your fill pipe marked?

Fill Location:
(Click approx. location eg. BL = back left)


Complete If You Are a Tenant

Landlord's Name

Phone

Does Landlord have an account?
YesNo

Account No.

Landlord's Address

City

State

Zip

Are you responsible for Service?
YesNo

Delivery Information

Tank Size

No. of Occupants

Current Volume in Tank

Home Square Footage

Would you like automatic delivery?
YesNo

Heating System Information

Type of Heating
SteamWarm AirForced Hot Water

Number of Zones

Is water heated by oil?
YesNo

Hot water heater make

Do you have a free-standing Unit?
YesNo

Do you have a tankless unit?
YesNo

Is your hot water storage tank connected to your boiler?
YesNo

Credit Information

Applicant 1:

Employer

No. of Years

Phone

Previous address (if < 2 years)

Applicant 2 (if applying jointly):

Employer

No. of Years

Phone

Previous address (if < 2 years)

Applicant #1 Signature

Date

Applicant #2 Signature

Date

I understand terms and conditions apply. Customer information is available by contacting the office..