1
Are you a BFA customer? YesNo
If you don’t have an account, please contact 1300 57 9990 or email sales@bulkfuel.com.au
2
Account Name
Street
Suburb
State Select StateNSWVICQLDWASATASACTNT
Postcode
Contact Name
Contact Phone Number
Contact Email
Please provide an email address if you wish to receive a confirmation.
3
Delivery Date Please select Date of Delivery. If it is a recurring order, please provide details (specific days etc) under ‘Special Instructions’
Type of Fuel Required Unleaded 91Premium 95Premium 98DieselAdBlue Please select the fuel type required. Choose one or more.
Purchase Order Numbers
Quantity – Unleaded 91
Quantity – Premium 95
Quantity – Premium 98
Quantity – Diesel
Quantity – AdBlue
4
Please provide any details that’ll assist our driver in successfully delivery of your fuel – eg. Call prior to arrival / Contact Site Manager for access / UHF Channel / or Equipment Type
We use local storage to improve your experience with our form by remembering the information you previously submitted. To find out more, read our updated Privacy Policy
We won't sell or rent your details. See our Privacy Policy.
