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Delivery Request

Important Notification

The form below is for Delivery Requests. Orders received today will be fulfilled by 10/03/2016, provided that you receive confirmation from a Proulx customer service representative.

DO NOT USE THIS FORM FOR EMERGENCY DELIVERIES

If we have any questions regarding this delivery, we will contact you on the next business day.

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

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