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Send Me Texts ◡̈Do Send Me TextsThis Phone Does Not Receive Text Messages Valley Energy Customer Account TypePlease select all of the following products and services your home or business receives from Valley Energy Residential Propane Residential Heating Oil Commercial Fueling Propane Grill Tanks Other Propane Customer+ What do you use propane for in your home?Select all that apply Home Heating Cooking Water Heater Pool Heater Fireplace Generator Dryer Other If you chose other, please explain.+Are you moving or planning on moving within the next six months?Propane Customer Yes No Maybe + If you answered "yes" or "maybe", please explain if possible.+ Do you plan on renovating, adding onto, or doing any major digging around your home in the next 6 months?Propane Customer Yes No Maybe If you answered "yes" or "maybe", please explain if possible.**Please inform us at least two weeks prior to any digging as we do need advanced notice to schedule a service technician to come out for any propane line marking.*+ Would you like to be sent information on any of the following?Select all that apply Propane Grill Tank Deals Commercial Fueling Station Valley Energy Hosted Events Tank Monitors Automatic Delivery SmartPay Billing PreBuy Online Portal Fireplace Cleaning Services Select AllHeating Oil CustomerIs heating oil used for your water heater? First Choice Second Choice Third Choice *Have you made any changes to your home heating system or do you plan to in the near future? Yes No *If you answered "yes" or – please explain if possibleIf you are thinking about making a change to your heating system, consider a switch to propane! Contact Valley Energy to learn more.*Are you moving or planning on moving within the next six months?Heating Oil Customer Yes No Maybe *If you answered "yes" or – please provide more information if possible* Would you like to be sent information on any of the following?Select all that apply Propane Grill Tank Deals Commercial Fueling Station Valley Energy Hosted Events Furnace Cleaning Services SmartPay Billing Automatic Delivery Online Portal None Of The Above Select All How likely are you to recommend Valley Energy? Very Likely Somewhat Likely Not Sure Not Likely Definitely Not Likely Any additional questions, comments, or feedback?Agreement I agree that all of the information I have provided in this form is correct and that Valley Energy may contact me regarding information shared in this survey. In addition, I understand that Valley Energy will use the provided answers to update my account if needed.SignatureYour NameYour NameYour NameYour NameCAPTCHA
