FUEL REQUEST FORM
For non-emergency service requests only

If you are out of oil or kerosene, or you have no heat,
please call 336-299-0531 (Greensboro), 336-887-1960(High Point)
or 336-784-6079 (Winston-Salem) for service.
 

Please fill out the form as completely as possible.
* Fields marked with an asterisk are required.

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I have:

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Account Number:

 

* Name:

 

Address:

 

City:

 

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Service / Product:

  Fuel Oil Delivery
  Dyed Kero Delivery

Please provide at least one phone number, and an email address so we may contact you.
** Please make sure your contact information is accurate. **
We respect your privacy.  We will not sell or distribute your contact information.

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PRODUCTS & SERVICES

  • Home Heating Oil and Kerosene
  • Gasoline and Diesel Delivery
  • Above Ground Fuel Oil Tank Installation
  • Commercial and Residential Deliveries
  • Natural Gas Systems, Oil Burners, Heat Pumps
  • Fuel for Emergency Generators at hospitals, nursing homes, manufacturing plants, computer labs, etc.

We also install and service heating and air conditioning systems through our Bain Heating and Bain Air Conditioning divisions.

SERVICE AREAS

  • Randolph County, Guilford County, Forsyth County, Davidson County, and areas of Rockingham County and Alamance County
  • Greensboro, High Point, Winston-Salem, Kernersville, Summerfield, Oak Ridge, Stokesdale, Colfax, Pleasant Garden, Reidsville, Browns Summit, Gibsonville, McLeansville, Whitsett, Julian, Jamestown and surrounding areas
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Bain Oil Company

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