Apply for a monthly fuel account and list the vehicles authorized to purchase fuel on your account.
Please enter the business or customer details for the account.
Only the vehicles listed here will be authorized to purchase fuel on this account.
Please review and confirm the account terms before submitting this application.
I understand that the account must be paid in full by the required payment date to receive the 2.5% discount. If only a partial payment is made, the discount will not apply for that account cycle.
I understand that a valid credit card on file is required for all accounts. A small test charge may be processed before approval to confirm the card is active and working.
I understand that the credit card copy required for my account cannot be submitted through this form or by email. A front and back copy must be provided in store at Wahta Convenience, or Wahta Convenience can make the front and back copy for me in store.
I understand that the account must maintain regular fuel purchase activity to remain active as a business / discount fuel account.
This application is subject to review and approval by Wahta Convenience.
This form does not guarantee approval. Do not include credit card numbers, CVV codes, or credit card images.
