Fuel Type * —Please choose an option—OilPropaneGasAir Conditioning

First Name *

Last Name *

Address 1 *

Address 2

City *

State *

Zip *

Phone *

Email Address *

Would you like your bills and statements emailed to receive $5.00 credit to your account * —Please choose an option—YesNo

Would you like Automatic Delivery? *

(Automatic delivery is self renewing each year at the rates in effect that year. if you do not want auto delivery please provide 30 days notice)

—Please choose an option—YesNo

Water Heater * —Please choose an option—OilGasElectric

Price per gallon —Please choose an option—Street PricePrice Cap

Tank size

I would like to apply for a service contract * —Please choose an option—YesNo

Date of Birth *

Spouse's Name (if applicable)

Credit Card Number *

Expiration Date *

Please select a method for payment *
Ten Day PaymentCredit Card AutoDirect Payment from Checking or Savings *Ten Month Budget **Budget Auto WithdrawalBudget Credit Card

*If you select to pay by credit card or direct payment please complete the Credit Card or ACH Authorization form.

**10 month budget starts in August. After August, contact the office to arrange

Please note if you elect credit card and Boyle Energy does not recieve the payment within 45 days your credit card will be charged

If your account becomes past due you will be assesed a 1.5% finance charge each month

Budget* —Please choose an option—YesNo

Would you like to include your Service Plan in your monthly budget? * —Please choose an option—YesNo

Comments*

Approximate usage previous season *

Service Plans
Comprehensive Oil Burner Service Plan $399Combo Comprehensive Oil & Air Conditioning Plan $501Comprehensive Gas/Propane Service Plan $299Comprehensive Oil Hot Water Heater Plan $149Comprehensive Air Conditioning Plan $299Comprehensive Heat Pump Plan $299Platinum Oil Burner Service Plan $433Combo Platinum Oil & Air Conditioning Plan $582Combination Gas/Propane & Air Conditioning Plan $439Comprehensive Gas/Propane or Electric Water Heater Plan $119Comprehensive Humidifier Plan $129

We'd love to know how you heard about us... *