New Service Application

Please complete this form to apply for NEW service only. All requests will be processed the next business day.  

Note: All fields with the asterisk (*) are required. Incomplete applications will not be processed.

AVECC Rates are available here.

Residential: 
Information on this application will be used for the purpose of a credit check through Experian. Depending upon the results of your credit check, you may be required to pay a deposit in full or partial prior to electric service being connected. Avoid high deposits with Prepay Power pre-pay service. With AVECC’s Prepay Power option, you have an opportunity to pay in advance for your electricity and avoid high deposits. Click here for more information about Prepay.

Please note that all applications for service are subject to approval and/or credit check. A membership fee of $25 and a connect fee of $10 is required and will need to be paid at the time of application along with a security deposit which is determined by a credit check. Any past due amounts to AVECC must be paid in full before new service can be established. 

Business: 

You will be required to pay a deposit in full or partial prior to electric service being connected.

Please note that all applications for service are subject to approval and/or credit check. A membership fee of $25 and a connect fee of $10 is required and will need to be paid at the time of application along with a security deposit. Any past due amounts to AVECC must be paid in full before new service can be established. 


Today's Date:  
Date Service is Desired:  *  
Type of Request:   *
Applicant Legal First Name:   *
Applicant Legal Last Name:   *
Applicant Middle Initial:  
Applicant SSN:-  -   *
Driver's License:  *
Driver's License State:   *
Applicant Date of Birth:  *  
Employer:  
Additional Adults Residing at Location 1:  
Additional Adults Residing at Location 2:  
Additional Adults Residing at Location 3:  
Additional Adults Residing at Location 4:  
Additional Adults Residing at Location 5:  
Additional Adults Residing at Location 6:  

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:   *
Service Type (Construction Required or Existing Service):   *
Meter #:
If there is not a meter please enter all zeros into the field area provided (exp. 000000)
 *
Location #:
10 digit number found on the meter base on green & silver sticker
  *
E-mail:  *
Confirm E-mail:  *
Home Phone:-  -    *
Cell Phone:-  -   
Business Phone:-  -     
Co Applicant Legal Name: 
Co Applicant SSN:-  -   
Co Applicant Driver's License:  
Co Applicant License State:  
Co Applicant Birth Date:    
Co Applicant Employer:  
Do you want this to be a Joint Membership?
(Please indicate yes or no)
 
Applicant Cell Phone Provider:
(NOT CO APPLICANT CELL PHONE PROVIDER)
 

Online Access:
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:

Have you ever had service with us before?    
Account Number:

IMPORTANT READ CAREFULLY: Your deposit will be determined by a credit check. A $25 membership fee and a $10 connect fee also apply. A customer service representative will contact you with your deposit amount.


Membership Fee:  
Connect Fee:  

As a convenience to our members AVECC offers many payment options including bank draft. If you are interested in signing up for automatic bank draft, please indicate “yes” in the field area and click here to complete the required bank draft authorization form.  
Is there an outdoor light at this location?  *
Would you like the outdoor light turned on?  *
If Rent, Name of Landlord:  
Landlord Address:  
Do you Own or Rent this location?  
Enroll in Operation Round Up?   *
Please select your preferred billing method:   *
 
*Cooperative will not use member provided contact information for marketing solicitations.
 
Having had an opportunity to read the AVECC Service Terms, Conditions and PrePay Terms and Conditions (if applicable), I agree. 

I give AVECC express consent to send SMS text alerts to inform me of account activity including account balance and usage information. If your mobile number changes, it is important that you contact AVECC to update this information. This will minimize interruption in your SMS text alerts service. 
I understand that checking this box and typing my name in the field provided below is my electronic signature.
  Applicant Name:     *