Apply Now - B20 Club of Indiana

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MEMBER INFORMATION
Name*
First Last
Title*
Company Name*
Company Address*
Street Address Address Line 2 City State ZIP Code
Email*
Phone*
FLEET INFORMATION
What blend of biodiesel do you use?*
- B5
- B11
- B20
- Other
- Blend varies during the year
- Don't know
Please Specify
How many gallons of this blend do you use per year?*
How many months of the year do you use this blend?*
How many miles does your fleet travel per year?*
How many diesel vehicles are in your fleet?*
How many of your diesel vehicles are 2007-2009?*
How many of your diesel vehicles are 2010 or newer?*
VERIFICATION DOCUMENTATION
Please provide fuel data (September 1, 2019 – August 31, 2020) to support the annual gallons used per year. This can be an Excel® spreadsheet with at least one document showing proof of purchase from distributor or fuel supplier indicating a purchase of B20 or greater blend being used.
File
Max. file size: 50 MB.
SIGNATURE
I certify that my answers are true and complete to the best of my knowledge. I understand that my membership in the B20 Club requires that my fleet continue to use B20 blends or greater as a fuel source.
Signature*
Name
This field is for validation purposes and should be left unchanged.

Membership Information