Apply for the Multi Service Fuel Card.

If you are a trucking company or an owner operator please complete this form and a representative from Multi Service will contact you within 24 hrs. Thank you.

Contact Information

Your Name:	Required
Your E-Mail Address:	Required

Company/Owner Information

Name of Company or Owner:	Required
Name of Owner/President:	Required
Street Address:	Required
City, State, Zip:	Required
Phone Number:	Required
Fax Number:
Year Business Started:

Trucks/Units

Number of Trucks:	Required
Percentage of OTR Fuel:
Current Fuel Provider:
Current Factoring Provider:

In order to approve your account, we may require additional information such as financial statements.