Are you a current member?(Required) Yes No Account NumberName(Required) First Last Phone Number(Required)Email Address(Required) Authorization to utilize Email Address(Required) Yes No Any Access Issues(Required)Gate codes, animals, etc. Light InformationType of Lighting(Required) Outdoor Security Light Streetlight(s) Requested Service(Required) Retire Outdoor Security Light Light is out Light is dim or flickering Other Pole Number(Required)Service Address of Outdoor Security Light(Required) Street Address Address Line 2 City ZIP / Postal Code Requested Service(Required) Light is out Light is dim or flickering Other Pole Number(s)(Required)Cross Street(s)(Required)Please provide the cross street, intersection where the problem light is located. Include any landmarks that may be helpful.Closest Address Street Address Address Line 2 City ZIP / Postal Code Additional Information(Required)Please add any additional information regarding repairs needed to a streetlight or security light or the retirement of a security light.Consent(Required) I agree to the privacy policy in the link below and all the work to be completed as described in this form.CEC Privacy PolicyElectronic Signature(Required)I certify the above information is true and correct and I am the person submitting this form.Type Full Name(Required)
Outage Map
