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Delivery Request

Important Notification

The form below is for Delivery Requests. Orders received today will be fulfilled by 07/04/2016, provided that you receive confirmation from a Proulx customer service representative.

DO NOT USE THIS FORM FOR EMERGENCY DELIVERIES

Delivery Requests will be confirmed by a Proulx Customer Service Representative.

Please note, it may take 1-3 business days for a delivery order made on line.

Please complete the form below to request a delivery.

Required fields are denoted with a red asterisk (*).

Fuel Type


*Fuel Type:
*Delivery Type: Fill Tank
150 Gals. (minimum delivery)

Customer Information


*First Name:
*Last Name:
*Delivery Address:
*City:
*State:
*Zip:
*Phone:
*E-Mail Address:

Proulx Account Information


If you don't currently have an account, click here to sign Up for a New Proulx Account

What is six+one?
  Why are you asking me this?
(enter your answer as a number, as in six+one=7)
 
 

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