Customer Sign-Up

 
 
 

We look forward to providing you with the best propane services in the area at our affordable prices! You have our promise that you have made the right choice.

Please submit this form below to start the process of becoming a Prism Propane customer. Please note all fields shown or outlined in red are required. A customer service representative will contact you soon after your application is received to welcome you to our ever-growing group of happy customers.

General Information

Are you a current Prism Propane Customer?
YesNo

Are you a previous customer of Prism Propane?
YesNo

If yes, what is your current or previous account number?

Type of service needed:
ResidentialCommercial

Mailing Address

Service Address

Is the service address the same as the mailing address? If so, the below address can be left blank. If not, please insert the address you wish to receive service below.

Email

Phone

Relative Contact Information

Employer Information

Addition Information

Are you a current propane user at the location you are requesting service for?
YesNo

If you answered "yes" then please provide us with the following information:

How full is your tank currently?

Please list everything anticipated to run off of propane at this location (click all that apply):

Furnace/BoilerWater HeaterRangeSpace HeaterClothes DryerFireplace/LogsGeneratorOTHER (describe in comments)

Comments and/or Questions?

captcha

Please insert the text exactly as shown in the image above into the box below.

Sign-Up Page - Sign-Up Button

Sign-Up Page - Truck Back

Sign-Up Page - Customer

Sign-Up Page - Prism Board

Sign-Up Page - Propane Fireplace

Sign-Up Page - Tank

Sign-Up Page - Penny Jar