The Fuel Club
Serving NH, VT, ME, MA, NY and RI
PO Box 568
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03-477-1940
Claremont, NH 03743 Established 1997 jerry@thefuelclub.com
New Member Enrollment Form
2021-2022 Membership Season
If you have questions, please visit our website or contact us. You MUST enroll with our program prior to our contract being set this
year in order to participate in our first round purchases. Once you are enrolled, your gallons will be added to our total for bidding.
We will begin to review our options for purchase shortly, but do not have a specific deadline for completing a contract.
Please return this form and your check (or money order) for dues to THE FUEL CLUB PO Box 568, Claremont, NH 03743.
Contact information (Please print clearly ):
Have you ever been a member of The Fuel Club in the past? ( ) Yes ( ) NO
Please complete for
all locations you wish to cover with your membership:
Primary Location
Main Fuel type/tank (check one) Oil ___ LP ___ Kero ____ Underground? Y N Home ($45) Business ($70)
Delivery Address____________________________________________________________ Town _______________________________
Current Supplier __________________ Account #____________________________
gallonestimate for 21-22 ________________
Additional fuel/tanks
($ 25 each
) : Oil ____ LP ____ Kero ____
Underground? Y N
# of add’l tanks $ 25 each
_____
Current Supplier __________________ Account #____________________________
gallon estimate for 21-22 ________________
Do you have more locations to be covered? Please attach a letter and include all of the information required above for
each location/tank you wish covered or we cannot guarantee price discounts for those locations.
Membership in The Fuel Club does not guarantee or imply that your current supplier will continue to serve your fuel
needs. The Fuel Club assigns your fuel supplier by availability of contracted gallons and geographic location.
My signature below, acknowledges that I have read and understood and accept the terms and conditions listed.
I understand tha
t I am purchasing a membership which will offer me the option to participate in a discounted pricing program for my
home heating fuel needs. I am under no obligation to accept the discounted price when it becomes available. Fuel supplier to be
determined based on bids, offers or geographic location. I understand it is my responsibility to complete and return the actual
contract for reserving fuel gallons, and that I will keep a copy for my records. Enrollment forms received without a signature and/or
membership dues will not be processed. Membership dues are non-refundable. Please call, or visit our website, for our full Terms
and Conditions of Membership. We will notify you with contact information regarding your assigned fuel supplier to establish an
account. The Fuel Club reserves the right to add or discontinue service with a fuel supplier at any time.
Signature: ______________________________________ Date: ________________________________
It is VERY IMPORTANT that you list your current supplier and account number above as this will make your enrollment easier for
everyone to have complete and accurate information. If your supplier is NOT one of our current contracted suppliers, we will
assign you one based on the information you provide on this enrollment, the availability of contracted gallons and geographic
availability of our contracted suppliers.
We will contact you confirming your enrollment with your membership account #.
Please send this completed/signed form with your member dues to: The Fuel Club PO Box 568 Claremont, NH 03743
Thank you for choosing the Fuel Club to keep you warm.
Name: _______________________________________________ EMAIL_____________________________________
Mailing Addr
ess: __________________________________________________________________________________
City : ____
________________________State: ________ Zipcode: _________Phone: ___________________________
