Name of Person Nominated*
Street Address*
City*
Tell us why this person is a good candidate for Split the Ticket*
Type of Fuel Needed*
Heating Oil
Kerosene
Propane
Current Fuel Provider
Choose from List Below
Allen Brothers Oil
Blair Discount Fuels
Blanchard Oil Company
Blouin Bros. Oil
Blue Flame Gas
Bourne's Energy
Brosseau Fuels
Clarence Brown
Cota's Propane Service
Cota & Cota
Dead River
Eastern Propane & Oil
Energy Co-op of Vermont
Fred's Energy
Fyles Brothers
Gillespie Fuels and Propane
Greene's Oil
HB Energy Solutions
Jack F. Corse
Jackman Fuels
James Oil Co
John Leo & Sons
Keyser Energy
Local Fuel Co
Marcell Oil Co
Mike's Fuels
Miles Fuels
Mirabito
Oil Supply Corp
Patterson Fuels
Proctor Gas
Rowley Fuels, Inc.
Simple Energy
Suburban
Superior Plus Energy Services
Trono Fuels
West Oil Company
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If there is a need for new heating equipment check the appropriate box below:
Oilheat Tank
Kerosene Tank
Boiler
Furnace
Water Heater
Your Name*
Contact Phone or Email*
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