Fill out this form to receive our senior citizen discount for customers 65 years and older.

Please fill the form out below or, if you prefer, print and complete this form and send to:

Mail: Austell Gas System, P.O. Box 685, Austell, GA 30168

Night Drop Box: 2838 Joe Jerkins Blvd, Austell, GA 30106

Fax: 770-948-8644