* Type of Customer:

Existing Customer:

New Customer:
* Name:	(First/Mid/Last)


* Type of Entry:


Lead Contact Information
Home Phone:
Work Phone:
Cell Phone:
Best Time to Call:
Email:
Street Address 1:	*
Street Address 2:
City:
State:
Zip Code:

Lead Account Information
Existing Customer:	Yes No
Account#:	(For existing customers)
Acquired Date:
Map:
Cross Street:
Current Co.:
Lead Source:	Other:
Equipment Information:
Existing Promo:	Yes No
Promo Details:
Interested In:	Other:

If Customer Referral
Name:	(First/Mid/Last)
Account#:
Contract:
Price:
Notes:

If Move-in:
Old Owner:
Annual Oil Usage:
Type of Heat:
Type of Hot Water:
Boiler Make:
Burner Make:
Oil Tank:
Location:
Account#:
Price:
Zones:

Customer Information

Existing Customer:

Yes No

Account Number:
(existing customer)

Remaining Balance:
(including installments)

Is Oil Ticket Out:

Zone:

Street Address 1:

City:

State:

Zip Code:

Email:

Phone Number:

Best Time to Call:

Tank Reading Date:

Closing Date:

Reason:

Moving
Cheaper Oil/C.O.D.
Delivery Complaint
Low Fuel Oil Consumption
Meenan Oil
Petro Group
Benit Fuel
Natural Gas Conversion
Free Service
Service Complaint

Credit Reject
Slomin's
Lewis Oil
General Util.
Deceased
Spill/Damage
Office Complaint
Friend in Business
Fuel CO-OP Group
Queens/Brooklyn Company

Old Homeowner Information

Forwarding Address :

City:

State:

Zip Code:

Phone Number:

Move-In-Date:

New Homeowner Information

Name:

Street Address 1:

City:

State:

Zip Code:

Phone Number:

Move-In-Date:


Lead Type:
Urgency:	(Where 5 is very urgent)
Status:
Received By:

*Customer Notes:

Please Login:

Add New Entry:
* = required

Lead Contact Information

Lead Account Information

If Customer Referral

If Move-in:

Customer Information

Reason:

Old Homeowner Information

New Homeowner Information

Please Login:

Add New Entry: * = required

Lead Contact Information

Lead Account Information

If Customer Referral

If Move-in:

Customer Information

Reason:

Old Homeowner Information

New Homeowner Information

Add New Entry:
* = required