Become a Customer

To become a Bel-Mar Oil Co. customer, please fill out the form below. Once you have submitted your application, you can login to the "My Account" area and start using the easy tools to manage your deliveries.

All Fields Are Required

Your Information
Customer Type:
Residential   Commercial

Your Name:

Mailing Address:

Delivery Address:
Same as mailing address

Home Phone:
() -
() -
() -

E-mail Address:

Delivery Information Tank Size:
Tank Location:

Fill Pipe Location:
Please select the location
of your house closest to your tank's fill pipe.

fill pipe location

Account Registration

To create an account please choose a username and password*. Your information will be save for future usage.



* Please choose a password at least 8 alphanumeric characters in length.
Security Question:

Security Answer: