Are you reaching out because you would like to change or upgrade something at a location that already has power from Heartland?* This field is required.

Yes

Name* This field is required.

First Name

Last Name

A note before you get started...

This form includes a save and resume feature. Instructions for computers and mobile devices can be found below.

If you're using a computer:

Click the save icon at the bottom of the screen.
On the screen that appears, click "Skip Create an Account".
Enter your email address and click "Send" to receive an email with a link to come back to your saved draft.

If you're using a mobile device:

Tap the status bar at the bottom of the screen where it says, for example, "2 of 21."
Tap the save icon at the top of the screen.
Tap "Skip Create an Account".
Enter your email address and tap "Send" to receive an email with a link to come back to your saved draft.

If you have any questions, please reach out to us at (800) 835-9586.

Current Mailing Address* This field is required.

Street Address

Street Address Line 2

City

State / Province

Postal / Zip Code

Country

Email Address* This field is required.

example@example.com

Phone Number* This field is required.

Please enter a valid phone number.

Do you already have service from Heartland Rural Electric Cooperative at this or any other location?* This field is required.

Yes

Heartland Account NumberYour account number can be found on your printed bill or online in your SmartHub account.

Are you ONLY looking to install a camper or RV outlet?* This field is required.

Yes

Service to be provided for: (select all that apply)* This field is required.

Home

Mobile home

Camper or RV

Barn/Shop

Other

What amperage do you need for your camper or RV?

Other

Is the service to be built at a lake?* This field is required.

Yes

At which lake is the property located?

Does the location at which you are applying for new service have a mailing address?* This field is required.

Yes

New Service Mailing Address

Street Address

Street Address Line 2

City

State / Province

Postal / Zip Code

Country

Nearest Intersection to Desired Service Location

New Service Location Information* This field is required.Please enter as much information as you can. Be sure to scroll through each field before continuing.

Type here:

Plat

Lot

Subdivision/Lake Area

Township

Range

Section

Unit

Plat

Lot

Subdivision/Lake Area

Township

Range

Section

Unit

Type here:

Please enter the square footage of the building:* This field is required.Please do not include the garage.

Primary Heating System (Please check one):* This field is required.

Heat Pump

Propane

Natural Gas

Electric Resistance Furnace

Electric Baseboard

Wood

Other

Please enter the kW used by your primary heating system:If you're not sure, we recommend you reach out to your HVAC installer.

Backup Heating System (Please check one):If you're not sure, we recommend you reach out to your HVAC installer.

None

Electric Resistance Heat

Natural Gas

Propane

Wood

Other

Please enter the kW used by your backup Electric Resistance Heat:If you're not sure, we recommend you reach out to your HVAC installer.

Electric AppliancesPlease select all of the ELECTRIC appliances you have installed or intend to install at this location.

Air Conditioner

Water Heater

Dryer

Range/Oven

Pool Pump

Spa/Jacuzzi/Hot Tub

Air Compressor

Welder

Electric Vehicle Charger

Pool Heater

Dishwasher

Sump Pump

Other

How many tons is your air conditioner?If you're not sure, we recommend you reach out to your HVAC installer.

Is your electric water heater a traditional unit with a tank, or a tankless/on-demand unit?

Traditional unit with tank

Tankless/on-demand unit

Please enter the kW used by your tankless water heater.

Which of the following are currently in place at the location to be served?* This field is required.

Water/Plumbing

Septic System

Foundation

None of these are in place yet

Is the property owned by someone other than the party filling out this application for new service?* This field is required.

YESNO

Please enter the property owner's name.

First Name

Last Name

Please enter the property owner's address.

Street Address

Street Address Line 2

City

State / Province

Postal / Zip Code

Country

Please enter the property owner's phone number.

Please enter a valid phone number.

Field Visit Information* This field is required.Be sure to scroll through each field before continuing.

Type Here:

Party to Contact:

Preferred time of day for field visit:

Phone number:

Party to Contact:

Preferred time of day for field visit:

Phone number:

Type Here:

Would you like information on security lights available for installation and rental from Heartland?* This field is required.

Yes

Do you plan to install a whole-house generator or battery backup system?* This field is required.

Yes

Are you interested in a meter-base transfer switch to allow for safe, easy connection of a generator to your home's electrical system?* This field is required.

Yes

Do you plan to install any form of distributed generation such as solar panels or wind turbines?* This field is required.

Yes

If you decide to move forward with service, will you want to add anyone else to the account?* This field is required.

Yes

Please enter the name(s) of any others you wish to have on the account.

If there is any additional information you would like to provide for this service, please use the space below.

Agreement to Accept Service: I hereby apply for electrical service as indicated herein. I understand that Heartland REC will make service available upon the completion of engineering details and a duly extended contractual agreement between the parties. I agree to accept service when construction is completed.* This field is required.If on a phone or tablet, use your finger to draw your signature in the space below. If on a computer, use your mouse or touchpad to draw your signature in the space below.

Clear

Application for New Service and Cost Summary