Hi Ho Enroll

Enroll with Hi-Ho
Name	*
Address:	*
City/Town	*
State	*	Zip*
Daytime Phone	*
Evening Phone	*
E-mail	*

Would you like to enroll into the automatic delivery program? Yes No
Would you like us to contact you with price protection information? Yes No
Would you like us to contact you about a service plan? Yes No
Would you like to enroll in our TankSure™ protection plan? Yes No
Do you have any questions that you would like a staff member to follow-up with you about?
Once completed, this form will be processed on the next business day.