New Customer | Hanover Propane Gas

Name*
First Last
Main Phone*
Other Phone
(if applicable)
Email
Enter Email Confirm Email
Address*
Street Address Address Line 2 City State ZIP Code
How would you like for us to contact you about this inquiry?*
- Phone
- Email
General Information
Are you interested in becoming an Auxier Gas customer?*
- Yes
- No
- Just shopping right now.
Would you like information about our service plans?*
- Yes
- No
What type of service do you need?*
- Residential
- Commercial
- Agricultural
- Camper
- Cylinder Fill
Please check all that apply.
What appliances do you have that use propane?*
- Fireplace
- Furnace
- Gas Logs
- Pool Heater
- Gas Dryer
- Greenhouse
- Range
- Forklift
- Grain Dryer
- Grill
- Generator
- Boiler
- Outdoor Heater
- Gas Post Lantern
- Other (please provide in the blank below)
Please check all that apply.
Other propane appliances not listed above:
Approximately how many gallons of propane do you purchase per year?
- 0-399 Gallons
- 400-2,999 Gallons
- 3,000 Gallons or Higher
- Not Sure
Do you know the size of your current tank?
- Yes
- No
- Not Sure
What is the size of your current tank?
Who is your current propane gas supplier?
Questions/ Comments:
Would you like to receive our monthly newsletter and any special promotions?
- Yes
- No, Thank you.
- Third Choice
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General Information