New Customer Registration - KiwiGas Christchurch

* EXISTING CUSTOMERS PLEASE ORDER USING THE LOG IN AND ORDER TAB*

If you want regular 45kg or any size gas bottles to your home, please register here. This will also count as the order for your first delivery.

If you are wanting a quote, please send an email to accounts@kiwigas.co.nz or call us on 0800 166 619

If you regularly want any type of commercial gas, please register with the commercial form here.

First Name *
Last Name *
Delivery Address inc Suburb *
Postal Address (if different)
Contact Number *
Email *
Number of cylinders *
Size of cylinders *
Preferred Initial Delivery Date *
New Connection?	Yes
Name of current gas supplier
Specific Requirements (access, conditions etc)
Next of Kin / Contact Person *
Next of Kin Phone number *
Landlord's Details (or state homeowner) *
Drivers Licence Number *
Drivers License Version Number *
Date of Birth *
Supply Agreement - Rental $50 per bottle per annum
What do you use LPG for?	Heating Cooking Hot Water Grain Dryer
Do we require a key for access?	Yes No
Do you have a dog? *	Yes No
Acceptance *	I have read and agree to the Terms and Conditions*