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  Become A Customer

   Areas Served | Commercial Fuels | Delivery | Maintenance | Equipment
Financing | Payment | Become a Customer

New Account Application


Western Petroleum appreciates each and every one of our customers and we welcome new customers to join our family.

   
Account Type
Title
First Name:
Last Name:
Date of Birth (mm/dd/yyyy):
Social Insurance #:
Company Name:
Email:
Street Address:
City / Town:
Province:
Postal Code
Telephone:
Mobile:
Fax:
Billing Address (if different than above)
Address:
City / Town:
Province:
Postal Code
Existing Customer?
Best time to Call?
Delivery Type?
Fuel Type?
Tank Location?
Is Your Tank Government Certified?
If Certified, Please provide Host #
Expiry #
   
Age of Tank?
First Delivery?
The date the first delivery is required by, MM/DD/YYYY
Average Annual Consumption?
Automatic Visa Payment?
Budget Plan?
   

I hereby certify the above information to be true and complete. I authorize and consent to Western Petroleum obtaining and exchanging credit information with any person or corporation with whom I have or propose to have financial relations.

I Accept

Signature:
(your name here constitutes signature)

   



Credit Applications


To set up an account with Western Petroleum, please complete the online form below. If you prefer, you can print, complete and fax/mail the following PDF credit application form. Be sure to indicate whether it is for a Personal Account or a Commercial Account. One of our representatives will follow up with you once we receive the application.

- Personal Credit Application

- Commercial Credit Application


Please fax completed forms to 709.643.9396

or mail to:

Western Petroleum
1 Main Street
Stephenville, NL, A2N 2Y9

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