New Service Form

Please complete the below application to apply for new service with South Kentucky RECC. A membership fee is required from all applicants. A deposit may also apply. Service connections occur during normal business hours, Monday through Friday 7:30 am to 4:30 pm. Service cannot be connected after business hours, on weekends or holidays. Any requests submitted after 3:00 pm will be processed the next business day. If you have any questions regarding connecting new service, please feel free to contact our office at 800-264-5112.

All fields with the asterisk (*) are required.

Today's Date:  
Date Service is Desired:  *  
Type of Request:   *
Customer First Name:   *
Customer Last Name:   *
Social Security #:-  -   *
Driver's License #:  *
License State:  
Birth Date:    
Employer:  
Date of Birth:  *

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

Service Address:
Please enter the address where service is required:
Service Address:   *
Service Type (Construction Required or Existing Service):   *
Comments:  
E-mail:  *
Confirm E-mail:  *
Home Phone:-  -    *
Cell Phone:-  -   
Busniess Phone:-  -     
Co Applicant Name: 
Co Applicant SSN:-  -   
Co Applicant Driver's License:  
Co Applicant License State:  
Co Applicant Birth Date:    
Co Applicant Employer:  
Co Applicant Date of Birth:  

Online Services:
We offer a varity of services from our website, including a system for viewing bills, paying bills and managing your account. Please specify an password to login to our online system.
Internet Password:  *
Confirm Internet Password:  
Password Hint:

Existing Service:
Do you currently have service with South Kentucky RECC?

    
Account Number:
Fee and Deposit Information:
A membership fee is required from all customers for service to be connected. A deposit may also apply. Once your account has been created in our system, you will receive an email with your new account information, including the total amount due on your new account.

Membership Fee:  

What type of home is it?
(House, Mobile Home, Apartment):		  *
What fuel source will be used for heat?
(Electric or Other):		  *
Do you own or rent at the service location?   *
Please select your preferred billing method:   *
 
By clicking here, the applicant (whether one or more) hereby applies for membership in the South Kentucky Rural Electric Membership Cooperative Corporation (Hereinafter called the Cooperative) and the Applicant and the Cooperative agree as follows.