Residential Application for Service
903-455-1715
membercare@farmerselectric.coop
*
Starred fields are required. If you don't have required
information, please contact us by phone or email.
Para Español
Service Location Physical Address
Owned
*
Rented
Existing Building
Construction hasn't started
Approximate square footage
Meter Number, if known
Requested Service Start Date
Start Service e.g. mm/dd/yyyy
Applicant
*
*
Date of Birth e.g. mm/dd/yyyy
*
*
*
This is a mobile number
*
This is a land line
*
I authorize the Cooperative to use this phone number to contact me by autodialed voice or text for any Cooperative-related purposes. You may be unable to use some current or future Cooperative programs and services, including outage announcements and updates, usage notifications, and courtesy termination calls, if you check “No.”
Additional Phone ?
Texas
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Utah
Vermont
Virginia
Washington
West
Wisconsin
Wyoming
Yes
No
This is a mobile number
*
This is a land line
*
I authorize the Cooperative to use this phone number to contact me by autodialed voice or text for any Cooperative-related purposes. You may be unable to use some current or future Cooperative programs and services, including outage announcements and updates, usage notifications, and courtesy termination calls, if you check “No.”
Yes
No
*
*
Please enroll me in Paperless Billing and send my monthly bills to my email address.
*
Co-Applicant ?
*
*
Date of Birth e.g. mm/dd/yyyy
*
*
*
This is a mobile number
*
This is a land line
*
I authorize the Cooperative to use this phone number to contact me by autodialed voice or text for any Cooperative-related purposes. You may be unable to use some current or future Cooperative programs and services, including outage announcements and updates, usage notifications, and courtesy termination calls, if you check “No.”
This is a mobile number
If an additional phone is entered, please select one of the following. ->
This is a land line
If an additional phone is entered, please select one of the following. ->
I authorize the Cooperative to use this phone number to contact me by autodialed voice or text for any Cooperative-related purposes. You may be unable to use some current or future Cooperative programs and services, including outage announcements and updates, usage notifications, and courtesy termination calls, if you check “No.”
*
Texas
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Utah
Vermont
Virginia
Washington
West
Wisconsin
Wyoming
Yes
No
Yes
No
Additional Information
I need information about your medical necessity program because a member of this household depends on an electric powered device to (1) prevent deterioration of a medical condition; or, (2) to sustain life.
The information you submit will be used to set up your account, to check your credit history, and to determine the amount of any required security deposit. We will contact you the next business day with your account information and fees.
We do not share your contact information with any other organization for any purpose not related to the business of the Cooperative.
Read our Privacy Statement
For assistance, please call 903-455-1715
or email membercare@farmerselectric.coop
Terms and conditions
I agree to the terms and conditions