Summer Fill 2025 Form
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Date
*
Account Number
Name
*
First
Last
Address
*
City
*
Contact Number
*
Email
*
Please list which propane tank(s) you would like filled for the Summer program:
Tank 1
*
Size of tank
Tank 2
Size of tank
Tank 3
Size of tank
Tank 4
Size of tank
Tank 5
Size of tank
The above-named customer agrees to participate in Tri-Energy Cooperative's 2025 Summer deferred program and understands propane will be delivered between June 1st, 2025, and August 31st, 2025. Payment will be due by September 25th, 2025, to avoid any additional fees. The minimum fill to participate in the program is 300 gallons.
Signature
*
Please e-sign agreement by typing your name.
Submit
