Customer Profile Form - Dine-Aglow Diablo Food Service Fuels

Purchasing Information

Purchasing Contact

First

Last

Purchasing Contact's Phone

Purchasing Contact's Email

Order Acknowledgement Submission Email

Where do you want your Order Acknowledgement from us to be emailed to?

Buying Group's Name

Marketing Information

Marketing Contact

First

Last

Marketing Contact's Phone

Marketing Contact's Email

Sales Team Information

Sales Manager's Name

First

Last

Sales Manager's Phone

Sales Manager's Email

File Upload - Upload Your Company Directory or Sales Rep Directory Here

Click or drag files to this area to upload. You can upload up to 3 files.

We made it easy... simply upload your company directory or sales rep directory so everyone at your company is included in our company and product announcement emails. (File formats accepted: PDF, Excel, Word, or TXT)

Accounting Information

Payables Contact Name

First

Last

Payables Contact Phone

Payables Contact Email

Invoice Submission Email

Where do you want your Invoice from us to be emailed to?

CFO's Name

First

Last

CFO's Phone

CFO's Email

Shipping Information

"Ship To" Company Name

Receiving Manager's Name

First

Last

Receiving Manager's Phone

Receiving Manager's Email Address

Shipping Receiving Hours

Additional Shipping Information

Sort and Segregate Required
Lift Gate Required
Residential Delivery
Delivery Appointment Required

Check All That Apply

Company Information

Purchasing Information

Marketing Information

Sales Team Information

Accounting Information

Shipping Information