Fuel Order Form

Thank you for choosing to place your order with TOTAL.  This form can be used by both new and existing customers. Please note it is mandatory to complete the asterisked (*) fields in the form below:

Contact Details
Island:*	Jersey Guernsey
Title *:
First Name *:
Surname *:
Address *:
Postcode:
Delivery address: (if different)
Delivery Postcode:
Telephone Numbers:	Home*: Work: Mobile: Fax:
Email Address:
Confirm Email address:
Account Details
Account Number (if known):
If you are a new customer and do not yet have an account set up with us, we will contact you shortly to discuss your options.  Please therefore tick the box below if you are a new customer to TOTAL.
I confirm that I am a new customer:
Delivery / Product Details
Product:	Domestic Heating Oil (also known as buring oil or kerosene) Gas Oil
Volume Required:	litres Minimum order: 400 litres Typical order: 900 litres
Delivery will normally take place within 5 working days.
If your order is urgent, please tick here:	Priority
Special delivery instructions (eg we will need to know if access to your tank or premises is restricted in any way):
Payment method:	Payment by Direct Debit Credit card (we will contact you for details)