Gladwin Application for Services Stanford LP Gas provides propane and related services for its residential and light commercial customers. To obtain our services, please complete the form below or complete and mail in this printable form. New Customer Form Stanford LP Gas provides propane and related services for its residential and light commercial customers. To obtain our services, please complete the form below or Name * First Name Last Name Date of birth * - Month - Day Year Date Social Security Number * Mailing Address * Street Address Street Address Line 2 City State / Province Postal / Zip Code Delivery Address * Street Address Street Address Line 2 City State / Province Postal / Zip Code Phone Number * - Area Code Phone Number Email * example@example.com Emergency Contact * Emergency Contact Phone Number * - Area Code Phone Number Employer/Department * Employer City * Please verify that you are human * The information furnished for the purpose of obtaining credit is warranted to be true. I hereby authorize complete investigation of this application with no liability there from. I agree to pay all bills within 30 days of purchase or as otherwise expressly agreed * Agree Submit Should be Empty: