URGENT  APPLICATION FOR SIGNALMAN PLUS 
or PLANNED TOP UP

Your Name:

Account Number

Address:

Post Code:

Telephone Number:

Fax Number:

Email Address:

Est. Annual Usage

  £        Litres
                                     
                     Fuel Type                

Please top up my oil tank
in the following months
Please note that we recommend

Signalman to guarantee against run outs.
January 2005
February 2005
March 2005
April 2005
May 2005
June 2005
July 2005
August 2005
September 2005
October 2005
November 2005
December 2005

Or....

Please Install / convert my current Signalman Plus agreement

Signalman Plus* at your annual fixed price with no monthly  charge
Signalman Plus* at your variable price with  monthly charge of £1.95 

* Terms and conditions available

LPG Cylinder Supply
47 kg Cylinders x per annum

 
How would you like confirmation of your Signalman application or fixed price acceptance

By Letter  By Email