New Member

*Indicates required field
Type of Service:

  Residential
  Commercial
  Single Membership
  Joint Membership
  Temporary
  New Permanent
  Existing (Meter Number Required Below)      
  Other

As a new member-owner, it is necessary to secure your account. Please choose one of the following options in order to process this application:

Provide a letter of good credit for one year from a current or previous electric service utility

Have a current Blue Ridge Electric member who has a one year good payment record with Blue Ridge Electric sign an account guaranty form which must be notarized. (Notarized Guarantee of Applicant?s Deposit)

Pay a security deposit based on two months electric usage (two highest bills) on the proposed permanent account. (You may pay with VISA?, Discover?, or MasterCard?, or in three partial payments)

Provide a satisfactory record from an established credit rating service. (You must pay credit reporting fees.)

Date Service is Needed: / /

Name on Account:


*First Name:
*Last Name:
E-mail Address:
*8-Digit Meter Number:(Required for EXISTING Service) Please do not enter all zeros in this space.


Rental agency, landlord or prior owner may be able to assist with this important information.

Date of Birth: (Required for credit rating ) / /
Home Phone: - -
Work Phone: - -
Cell Phone: - -
Billing Address:
City:
State:
Zip Code: -
Street Address:
City:
State:
Zip Code: -
Driver's License Number:
Driver's License State:
Applicant's Place of Employment:
Co-Applicant's Name: (Considered a JOINT membership.)
Former Blue Ridge Member? Yes No
If Yes, When?:
Spouse's First Name:
Spouse's Last Name:
Nearest Relative Not Living With You:
First Name:
Last Name:
Relationship:
Telephone Number: - -
Address:
City:
State:
Zip Code: -
Building Contactor (if applicable):
Telephone Number: - -

Location (directions to home site):

Comments:


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