New Customer Application

We're happy every time we sign up a new customer, and we make it our business to treat you like a VIP - both now and for many years to come!

Fill out the form below to begin the process of creating an account with Bottini Fuel. A customer service representative will contact you to finish setting you up.

Applicant Information
Please choose a First Name.
Please choose a Last Name.
Please choose a Address Line 1.
Please choose a City.
Please choose a State.
Please choose a Zipcode.
Please choose a Phone.
+1
Please choose a Email Address.
Please choose a Own or rent.
Preferred contact method
Best Days to contact you
Tank Information
Tank Information * Select Product
- Tank Fill Location