MEMBERSHIP APPLICATION AGREEMENT AND SERVICE CONTRACT
Thank you for requesting service with Fort Loudoun Electric Cooperative. To request new service be connected, please complete the information below. A Member Service Representative will contact you within one business day to complete the application process or you will receive an automated email once your account has been officially created in our system.  If you have any questions regarding new service, please contact our office during normal hours 1-877-FLEC-ORG (1-877-353-2674).

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


Today's Date:  
Date Service is Desired:  *  
Type of Request:   *
Applicant Information:
First Name:
  *
Last Name:   *
Social Security No.:-  -   *
Drivers License No.:  *
License State:   *
Date of Birth:    
Employer Name:  

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

Service Address:
Please provide the physical 911 address.
Service Address:  
Comments:  
E-mail:  *
Confirm E-mail:  *
Home Phone:-  -    *
Cell Phone:-  -    *
Employer Phone:-  -     
Spouse Information:
Name:
 
Social Security No.:-  -   
Driver's License No.:  
License State:  
Date of Birth:    
Employer Name:  

Online Access:
We offer a portal for online bill payment and account management. If you would like access to your account online, please create a password and password hint below. Please note passwords must be a combination of letters and numbers.
Internet Password:  
Confirm Internet Password:  
Password Hint:

Existing/Previous Service:
Have you ever had service with Fort Loudoun Electric Cooperative?
    
Account Number:
Fee and Deposit Information:
Each prospective member requesting electric service will be required to pay a $5.00 membership fee and a $10.00 service fee.  Deposits are based on the information as provided below.  When your account is created in our system, you will receive and email including the total amount due on your new account, including deposit amount, if applicable.

If you are interested in waiving your Deposit, click here for more information on our Prepay option.

Residential:
Home owners and renters will undergo a credit assessment to determine the deposit options as listed below:

1. Based on credit assessment the deposit may be waived.
2. If a deposit is required, the minimum deposit shall be twice the average amount of the bill at the location.
3. The credit check will determine the deposit amount required.

When paying any deposits/fees over $2500, please be prepared to pay by cash, check or money order in our office. FLEC cannot accept credit or debit card charges over $2500.

A member with 24 months good credit history will be eligible to receive the deposit back in the form of a credit to them on their bill, including members on/in rental agreements. (Good credit means having no more than two late payments in a 24 month history.)
FLEC is now required to accrue interest on deposits held over 12 months. This amount will be applied as a credit on the account.

Upon termination of service, any deposit will be applied against unpaid bill and if any balance remains after such application, said balance will be refunded to member. 
 
Commercial:
Click here to read more information on Commercial deposits.

FLEC is required to treat everyone in a class the same, regardless of tax exempt status. Non-profit organizations will now be required to pay a deposit or provide a letter of credit, Certificate of Deposit, or some form of security for the accounts.

Membership Fee:  
Service Fee:  

Relative:
Name:
 *
Street Address:  
City, State, Zip:  
Do you own or rent?   *
Please select preferred Billing Method:   *
 
This application agrees to the terms and conditions that are stated in the By-Laws, policies, rules, and regulations of the Cooperative which are in effect at the present time and which may change from time to time as adopted by the Cooperative. The applicant agrees to pay reasonable costs and attorney’s fees incurred by the Cooperative in the collection of any unpaid electric bills due to the Cooperative. The applicant also agrees to pay delinquent charges such as late payment charges, collection charges and return check charges as may be established by the Cooperative in regards to delinquent accounts. In addition, the applicant agrees to pay any recurring charges that may exist at the location for providing service to the premise.

Further, the applicant grants to the Cooperative, its successors and assigns, the right to enter upon, and to place, construct, repair, maintain, replace, or relocate thereon electrical distribution poles, lines, appurtenances, and other facilities, and to do all acts necessary in said construction, operation, maintenance, or repairing of said facilities at the sole discretion of the Cooperative. Necessary acts may include the cutting of all trees directly under any of the Cooperative’s lines, cutting or trimming all trees within the Cooperative’s 40’ right of way (20’ on either side of line), or removal of any obstacle that might become an object of interference in the construction, operation, maintenance or repairing of said electrical poles, lines, appurtenances, and other facilities. 

Further, the Cooperative’s employees shall have access to applicant’s premise at all reasonable times for the purpose of reading meters, testing, repairing, removing, or exchanging any or all equipment belonging to the Cooperative. 

Each party by affixing his/her signature below agrees that the above information is correct and agrees to the above stated terms and conditions and to accept full responsibility for the electric bill for this account. By signing the applicant agrees that if fees and other charges have been paid but service was not activated in a reasonable amount of time, the Cooperative reserves the right to void said application and contract at which time funds being held would be refunded to the applicant if service or parts of services are not rendered.

By signing this application the applicant authorizes the Cooperative to obtain credit information regarding the applicant from the trade references and credit reporting agencies. Based upon this information the Cooperative may require the applicant to make a deposit.
I understand that checking this box and typing my name in the field provided below is my electronic signature.
  Applicant Name:     *