Application for Electric Service

If you are ready to turn on the power, it's time to fill out an application!  To request electric service with Coweta-Fayette Electric Membership Corporation, please complete the below application. If you have any questions, please feel free to email customer service.

Note: All * are required fields.

Today's Date:  
Date Service is Desired:  *  
Type of Request:   *
First Name:   *
Last Name:   *
Middle Initial:  
Social Security #:--  *
License State:  
Birth Date:    

Mailing Address
Please enter the mailing address where bills should be sent:

Street Address/P.O. Box:  *
City:  *
State:  *
Zip Code:   *

Service Address
Please enter the street address where service is required (if different):

Service Address:   *
Service Type (Construction Required or Existing Service):   *
E-mail:  *
Confirm E-mail:  *
Home Phone:--   *
Cell Phone:--  
Work Phone:--   
Co Applicant Name: 
Co Applicant SSN:-- 
Co Applicant Driver's License:  
Co Applicant License State:  
Co Applicant Birth Date:    
Co Applicant Employer:  
The best time to reach me is:  

Online Access
As a convenience to our customers, we provide an online application for viewing and paying bills. If you would like to use this service, in the section provided below, please specify an Internet Password and Password Hint for online account access. For security purposes, please specify a password that is at least 4 characters in length.

Internet Password:  
Confirm Internet Password:  
Password Hint:

Existing Service 
Do you currently or have you previously had service with Coweta-Fayette EMC ?

Account Number:

Fee & Deposit Information
A $25.00 Membership Fee is due with the Application for Service. In addition, a security deposit may also be required. The depsoit amount is determined based on a credit check. When your account is created, you will receive an email with the total amount due on your new account, including the deposit amount, if applicable.

Membership Fee:  

Please select your preferred Billing Method::   *
I agree as follows:
By submitting this request, I have read and understand the Service Rules and Regulations of Coweta-Fayette Electric Membership Corporation.  I also understand that a credit check will be submitted to determine if a security deposit is required.