<p>LS Fuel Co-op Phone (603) 863-2430 PO Box 664 Fax (603) 863-8353 Newport, NH 03773 [email protected]</p><p>2015-2016 FUEL CO-OP ENROLLMENT FORM ONLY ______</p><p>EMAIL: ______</p><p>BY SELECTING A SUPPLIER YOU ARE NOT LOCKED INTO THAT SUPPLIER UNTIL YOU HAVE SIGNED THEIR ACTUAL FUEL CONTRACT. ______Directions:</p><p>1. Select ONE Oil Company - PLEASE MAKE SURE YOU ADD YOUR ACCOUNT NUMBER IN THE BOX PROVIDED</p><p>Account Number Irving Energy Dead River Patriot Fuels </p><p>Number of Gallons requested ______</p><p>2. Pay your Annual Non-Refundable Co-op Fee of $25.00 and check one:</p><p>Enclosed is my check, made payable to LS FUEL CO-OP</p><p>Please call to schedule my Annual Cleaning (Daytime Phone #) ______</p><p>Charge my Annual Co-op Fee to my Credit Card ______</p><p>Card Number Expiration Date</p><p>______Name on Card (Please Print) Signature</p><p>3. Return  Your Co-op Fee Check with this Signed form. Must sign above if paying by credit card </p><p>*Please Read and sign acknowledging that you understand and agree to LS Fuel Co-op Enrollment*</p><p>I understand that this is the Enrollment Form Only, in which it allows me the OPTION to participate in the discounted fuel pricing program for the upcoming heating season. I understand that the Enrollment (Administrative) Fee is Non-Refundable and am aware that I am under no obligation to accept the discounted price when it becomes available. It is also my responsibility to complete, sign and return the CONTRACT to the supplier of my choice (and retain a copy for my records, if I do not receive a contract it’s my responsibility to contact LS Fuel Co-op). **Enrollment forms received without a Signature and/or Enrollment Dues will not be processed**</p><p>Signature: ______Date: ______IRVING ENERGY MEMBERS</p><p>IRVING ENERGY IS OFFERING 2 GREAT PRICING PROGRAMS FOR THE 2015-2016 HEATING SEASON: #2 HEATING OIL  "RACK PLUS OFFER" - THIS IS THE PRICE YOU WILL PAY ON THE DAY OF DELIVERY. THIS PRICE WILL FLUCTUATE DAILY. (NH & ME IS $.42 CENTS FIXED ADDER OVER THE DAILY IRVING OIL PORTSMOUTH HEATING OIL RACK PRICE – VT FIXED ADDER IS $.45 CENTS OVER THE DAILY IRVING OIL REVERE WHOLESALE LOW SULPHUR HEATING OIL RACK PRICE.)</p><p> "FIXED PRICE OFFER" - IRVING ENERGY'S FIXED PRICE WILL BE PRICED AT A $.10 CENTS PER GALLON DISCOUNT OFF IRVING'S DAILY POSTED FIXED CREDIT PRICE FOR THE WEST LEBANON, NH LOCAL MARKET. MUST CALL IRVING ENERGY BEFORE OCTOBER 31, 2015 FOR A WRITTEN CONTRACT.</p><p>PROPANE</p><p> "RACK PLUS OFFER" - ALONG WITH NET 30 OR BUDGET PAYMENT OPTIONS</p><p>VOLUME TIER FIXED ADDED OVER DAILY PRICE OPIS SELKIRK PRICE 0-500 Gallons $.99 per Gallon 501-1000 Gallons $.80 per Gallon 1001-1500 Gallons $.70 per Gallon 1501 and Over Gallons $.65 per Gallon</p><p>MEMBERS REQUESTING FIXED PRICE OFFERS MUST CONTACT IRVING ENERGY TO REQUEST A CONTRACT NO LATER THAN OCTOBER 31, 2015. (AFTER YOUR ENROLLMENT HAS BEEN PROCESSED)</p><p> "FIXED PRICE OFER" - MEMBERS WILL BE GIVEN A DISCOUNT OFF PROPANE OF $.25 CENTS OFF IRVING ENERGY'S DAILY POSTED FIXED CREDIT PRICE FOR THE WEST LEBANON, NH LOCAL MARKET. ALSO MUST CALL IRVING ENERGY BEFORE OCTOBER 31, 2015 FOR A WRITTEN CONTRACT. ______</p><p>PATRIOT FUEL CO. </p><p> STILL OFFERS CO-OP PRICING. ______</p><p>DEAD RIVER OIL CO. Price Protection Fee $.20 (also offers Kerosene Pricing) #2 FUEL  "EASYCAP BUDGET" - $2.799  "FIXED BUDGET" - $2.799  " PREBUY" - $2.599 Cash For Propane Pricing please call.</p>