Luckey Farmers Online Petroleum Order Form

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Thank you for choosing to purchase fuel with Luckey Farmers! Fill out and submit the form below to place your order online. A Luckey Farmers representative will follow-up within two business days from the time of submission.

First Name *

Last Name *

Address *

City *

State *

Zip Code *

E-mail *

Phone Number *

Billing Method *

Please select one of the following options

I have a Luckey Farmers Co-op Account

I will leave a check at the door

I will prepay at the office

Select Product 1

Are you ordering Product 1 by Gallons or Dollars?

Choose to order by fuel volume or dollar amount

Gallons

Dollars

Clear selection

Product 1 Amount

How many gallons or dollars of Product 1 are you ordering?

Select Product 2

Are you ordering Product 2 by Gallons or Dollars?

Choose to order by fuel volume or dollar amount

Gallons

Dollars

Clear selection

Product 2 Amount

How many gallons or dollars of Product 2 are you ordering?

Please double-check your order for accuracy, then click "Submit" below to send your order.

Submit

Clear form

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