Become A Member

Company Name*

Street Address*

Street Address Address Line 2 City State ZIP Code

Billing address is the same as street address

Yes
No

Billing Address*

Street Address Address Line 2 City State ZIP Code

Phone*

Fax

Email*

Website

Type of Membership*

Fuel Oil Dealer (Complete dealer worksheet)
Fuel Oil Marketer (Large Marketer $3,000/yr)
Fuel Oil Marketer (Small Marketer $650/yr)
Equipment Supplier ($450/yr)
Associate Member ($450/yr)

Type of Business

Corporation
LLC
Partnership
Sole Proprietor

How long have you been established?

Contact Name*

First Last

Contact Title

This section to be completed by oil dealers only

THE FOLLOWING INFORMATION WILL BE HELD IN STRICT CONFIDENCE. Gallons of #2 fuel oil/bioblend sold (in Rhode Island only) from June 1, 2020 to May 31, 2021.

Total Gallonage

One-Year Dues Amount:

Monthly Payment:

Payment Information

I will pay my bills by:*

Check
Credit Card

Please bill me:*

Monthly (oil dealers only)
Quarterly*
Annually

*New Associate Members must pay an annual fee for the first year then can be billed quarterly thereafter.

The above information is completed in full to the best of my knowledge.

Electronic Signature*

I would like to join the Energy Marketers Association of Rhode Island mailing list

Yes
No

Join EMARI

This section to be completed by oil dealers only

Payment Information

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