"*" indicates required fields EmailThis field is for validation purposes and should be left unchanged.Is this application personal or for a business/organization?* Personal Business/Organization Applicant Name:* First MI Last For organizations, input primary contact name in this fieldIs this application for a joint membership (more than one individual responsible for the bill)?* Yes No Joint Applicant Name: First MI Last Organization/Business Name:*Will the area where this service provides power be used primarily for residential purpose?* Yes No Primary Contact:* First MI Last For organizations, input primary contact name in this fieldRequested Service Start Date (MM/DD/YYYY):* Month Day Year Please select the date you would like service to begin. The date cannot be more than 30 days in the future. If you already have existing service at this location, please enter todays date.Do you own or Rent?* Own Rent Landlord/Owner Name:*Landlord/Owner Phone*Do you plan to live at the property or rent to another individual?* Live at the property Rent to another individual CEC Service Address:* Street Address City State AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Does your address include a unit or apartment designation?* Yes No Unit or Apartment Designation*Would you like to take over service for all meters at this service address?* Yes No Many locations have multiple meters including a house, shop, well or irrigation accounts. Select yes if you would like to take over service for all accounts at this specific service address.Are there any meter access issues we should be aware of?Such as animals, or if the meter is located behind a locked gate. Please provide all gate codes for our crews to be able to gain required access to the system. CEC requires access to CEC metering equipment at all times.Mailing Address: Same as as Service Address? Street Address City State AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Email:* Primary Phone:*Type:* Mobile Landline Secondary Phone:Type: Mobile Landline By providing CEC with the above phone number(s) and email address, you are giving express written consent to contact you via these channels for outage notifications and other CEC specific business purposes. You may setup or turn off specific notifications to be sent to you via email or text in your SmartHub account. You may opt out at any time by contacting CEC in writing (email or letter).Have you previously had service with Central Electric Cooperative?* Yes No Previous service address:Would you like to enroll in paperless billing?* Yes No Would you like to enroll in Project Helping Hand?* Yes No Join with other Central Electric members in an effort to help our less fortunate neighbors with their electric bills when they encounter overwhelming financial difficulties. By joining, you agree to donate a few cents per month by allowing our billing department to round up your monthly bill to the next full dollar. For example, if your monthly bill was $74.67, your bill would be rounded up to an even $75.00 and the extra 33 cents would represent your donation. You can also elect to add a set amount each month to your donation. Your donation of some small change can make a big difference in the lives of your neighbors. It’s the co-op way.How much would you like to donate?* Round up only (From minimum $0.12 to maximum $12 per year) Round up plus a fixed amount Additional monthly donation to Project Helping Hand*Please enter the amount you would like to add to the round up amount each month.How would you like to receive the Ruralite Magazine?* Printed and Mailed Digital CEC provides a monthly publication called Ruralite. This publication is used to convey a monthly message from your CEO & President, as well as additional important information about what is happening at CEC. Please select if you would like to receive a printed and mailed or digital copy of the Ruralite Magazine.Central Electric Cooperative, Inc. CEC is a member-owned, not for profit, cooperative and only members may receive electric service. Every natural person or entity desiring electric service must make an application for membership by contacting CEC and providing required personal and other information. The “application for membership” is only a request for service and does not, in itself, constitute a contract for service until CEC commences delivery of electric service to the member. Terms and Conditions*The above named Applicant(s) hereby applies for membership with CEC and in consideration of the acceptance and approval of this Application by CEC, agrees to the following terms and conditions: Applicant has the opportunity to review the Customer Service Policy, the Rate Schedules, and the CEC Bylaws, as may be amended, changed, or otherwise modified from time to time. Terms and Conditions* The delivery of service by CEC shall confirm acceptance of such membership application; and the commencement and continuation of service also confirms member’s acceptance of all the terms and conditions described herein. Before signing and submitting this application, PLEASE review the full CEC Customer Service Policy and Bylaws located at any of our offices or online with your SmartHub account, and also review the current Rate Schedules, which are available online at www.cec.coop. Terms and Conditions* Members are required to pay a non-refundable five (5) dollar membership fee billed on their first billing statement. Each membership is entitled to one vote according to CEC By-Laws. Membership includes a yearly subscription to Ruralite Magazine which provides information and announcements important to membership. Its costs are included in the cooperative’s cost of providing electric service. Terms and Conditions* The personal information collected by CEC is used only when and to the extent necessary and appropriate to provide and improve services. It is your responsibility to update CEC of any changes to your personal information. Terms and Conditions* Because electric service is used prior to meter reading and billing for such service, CEC, in its sole discretion, may require a deposit as a guarantee to cover payments for anticipated service. CEC may accept a known credit history in lieu of a deposit. In the absence of a known credit history, an acceptable letter of good credit from the applicant’s past electric utility may be considered by CEC in lieu of a deposit. CEC also offers a Prepaid Program, for qualifying account types. No deposit is required for CEC Prepaid Program. Terms and Conditions* CEC shall be granted, at no cost, all rights-of-way and easements necessary to serve the customer, overhead or underground, for the erection, maintenance, repair, replacement, removal, or use of all wires, poles, machinery, fixtures, or equipment needed to supply and deliver electric service to that member and members who require service from that line. CEC, through its authorized employees, contractors, and agents, shall have access to its equipment at all reasonable times, for the purpose of inspecting, reading meters, and testing, repairing, replacing and/or upgrading, any equipment which is the property of CEC. If such equipment is so located that locks or security devices must be operated to reach it, CEC shall be provided appropriate access. Terms and Conditions* The service will be disconnected for power diversion, tampering with CEC equipment, failure to pay electric charges or deposit when due and owed, breach of service agreement with CEC, dangerous or emergency conditions exist at a member’s service premises, or failure to provide access to meters or other CEC equipment. Terms and Conditions* All bills are due on receipt and become delinquent 15 days from the date of billing. Outstanding balances on inactive accounts will be turned over to a collection service after reasonable attempts have been made to collect in-house. Terms and Conditions* CEC will use reasonable diligence to provide satisfactory and uninterrupted single-phase or 3-phase electric service, but cannot guarantee such service and shall not be liable for injury, loss, or damage resulting from any failure or curtailment of electric service, nor shall such failure or curtailment constitute a breach of any agreement with the customer. Primary Applicant Consent*By checking this box and typing my name, I certify that all information on this form is true and correct and I am following the terms and conditions outlined above. I also agree that the checkbox and my name typed below are to be used as my electronic signature. I understand that I can be held liable if I provide false or misleading information. I certify the above information is true and correct and I am the person submitting this form. Primary Applicant Full Name:*Joint Applicant Consent*By checking this box and typing my name, I certify that all information on this form is true and correct and I am following the terms and conditions outlined above. I also agree that the checkbox and my name typed below are to be used as my electronic signature. I understand that I can be held liable if I provide false or misleading information. I certify the above information is true and correct and I am the person submitting this form. Joint Applicant Full Name:Consent* I agree to the privacy policy in the link below:CEC Privacy Policy
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