home » customer service » 3 in 1 Propane, Methane and CO Detector Order Form

3 in 1 Propane, Methane and CO Detector Order Form

Proulx Oil & Propane sells the 3 in 1 Propane, Methane and CO Detector at a special introductory offer of $84.99 shipped directly to you. Please fill out this form to order. Required fields are denoted with a red asterisk (*).


Credit Card Information


*First Name on Card:
*Last Name on Card:
Company:
*Billing Street:
*Billing City:
*Billing State:
*Billing Zip Code:
*Credit Card Type:
*Credit Card Number:
*Expiration Date (mm/yy): /
*CVV:
  What is a CVV?
*Quantity Requested: at $84.99/each (plus $14.99 shipping per order)
RECOMMEND MIN. 1 per FLOOR in your home
(e.g. basement, first, second = 3 total)

Shipping Information


If you wish to ship the device(s) to a different address than above fill in your shipping address below.

Shipping Street:
Shipping City:
Shipping State:
Shipping Zip Code:


Contact Information


*Phone Number:
Fax Number:
*Email Address:


Additional Information


Comments:

Would you like to receive email reminders and special promotions from Proulx?
  Yes, please notify me
No, thanks
 
What is seven+six?   Why are you asking me this?
(enter your answer as a number, as in six+one=7)