Midway Oil Order Form

Your Name (required):

Mailing Address:

City, State   Zip:

Phone Number:

Email (required):

Delivery Address:

Number of Gallons (Oil) or Tons (Pellets):

Type of Fuel:         #2 Heating Oil         Mobil Home Blend
                                   Inferno Wood Pellets         Spruce Pointe Wood Pellets

Method of Payment:         Credit Card         Check         C.O.D.

Comments — Brief Description of House and Location of Pipe:


Please add me to your email list

Please enter the following Security Code:

Security Code: