Rockgas Hamilton

P.O.Box 10-400
Te Rapa
HAMILTON 3241

FREEPHONE: 0800 234 548

PH: 07 850 6079

orders@rockgashamilton.co.nz

* denotes a mandatory field.

Title
First Name *
Surname *
Date of birth
Address of property requiring LPG
Postal address if different from above
Contact phone number *
Email address
Do you own the property?
If renting, please include landlord's name, address and contact phone number
What will the LPG be primarily used for?
Special delivery instructions?