Residential Membership Application Instructions
This application is for an individual or an individual and their spouse only. Privately owned businesses that file tax returns under the owner’s social security number should also use this form with the membership held in the owner’s name(s).
Married persons are not required to have a joint membership. Either spouse can have the membership in his/her name; however capital credits will be in the name of the member only.
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Please complete the application as indicated on the form, and complete the Information Form.
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A $5.00 membership fee is required to become a member of the Cooperative. The $5.00 membership fee will be billed on your first electric statement. The Cooperative will retain the membership fee until you terminate all active electric services.
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Upon receipt of the application, a credit report will be ordered and a deposit may be required. Deposits are refunded to the member(s) account after 12 consecutive on-time payments of their electric billing. The Cooperative offers prepaid service as an alternative to paying any required deposit.
Be sure to click the submit button at the end of the last page of this online form to send us your completed application. Our office must receive all of the completed forms and deposit (if required) before the electric service will be connected.
Thank you,
Heartland Rural Electric Cooperative, Inc.