Country Gas - Refer a Friend

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Get a $100 credit for you and your friend when they sign up based on your referral!*

First Name:
Last Name:
Country Gas Account Number:
Address Line 1:
Address Line 2:
City:
State:
Zip Code:
Phone:
Email:

REFERRED COUNTRY GAS CUSTOMER INFORMATION

First Name:
Last Name:
Address Line 1:
Address Line 2:
City:
State:
Zip Code:
Phone:

*Credit occurs on the day the referred's tank is delivered! Offer excludes customer owned tanks. New Customer only with 500 gallon tanks or larger.

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