Become a Customer

To become a customer, please fill out the form below. Once you have submitted your application, you can login to the "My Account" area and start using the easy tools to manage your deliveries.

All Fields Are Required

Your Information
Your Name:


Delivery Address:



Mailing Address:
Same as delivery address



Home Phone:

Cell:


I would like to receive text messages from JC Discount Fuel.
Work:


E-mail Address:

This will be used to log in to your online account.
Delivery Information
Fuel Type:  Heating Oil  
Customer Type:  Residential    Commercial  

Tank Size:
Gallons


Tank Location:

Fill Pipe Location:
Please select the location of your house closest to your tank's fill pipe.


fill pipe location



Account Registration

To create an account please choose a password*. Your information will be saved for future use.


Password:
* Please choose a password between 8-20 alphanumeric characters in length.

Security Question:

Security Answer: