Application For Membership And Electric Service

Note: All fields with the asterisk (*) are required.

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

Please enter the address where bills should be sent:
Street Address/P.O. Box:  *
City:  *
State:  *
Zip Code:   *

Please enter the street address where service is required:
Service Address:   *
Comments:   *
E-mail:  *
Confirm E-mail:  *
Home Phone -  -    *
Cell Phone:-  -   
Business Phone-  -     *
Spouse Applicant Name:  *
Spouse Applicant SSN:-  -   
Co Applicant Driver's License:  
Co Applicant License State:  
Co Applicant Birth Date:    
Co Applicant Employer:  

As one of our services, we provide an online application for viewing and paying bills. If you'd like to use this service, you can specify an Internet Password and Password Hint at this time. Please note that the Internet Password must be at least 4 characters in length.

Internet Password:  
Confirm Internet Password:  
Password Hint:

For Commercial accounts, please contact the office for more information


By checking this box, I (hereinafter called the "applicant"), hereby apply for membership in, and agree to purchase electric energy from SPRINGER ELECTRIC COOPERATIVE, INC. (hereinafter called the "Cooperative"), upon the following Terms and Conditions:

1. The Applicant will pay to the Cooperative the sum of $5.00 which if this application is accepted by the Cooperative, will constitute the Applicant's membership fee. (Not applicable if consumer is already a member.) Also Required: A deposit or letter of credit with less than 3 late payments in the last 12 months from a current utility. NOTE: If Applicant has a bad credit rating with the Cooperative from a past account, Applicant will be required to pay the deposit and a letter of credit will not be accepted.

2. The Applicant will, when electric energy becomes available, purchase from the Cooperative all, except to the extent that the Application is generating its own power, electric energy used on the premises described below and will pay therefore monthly, at rates to be determined from time to time in accordance with the by-laws of the Cooperative; provided, however, that the Cooperative may limit the amount of electric energy to be furnished for industrial uses. The applicant will pay a minimum bill regardless of the number of kilowatt hours consumed, plus amounts stated below, if applicable.