Sign Up for Service

Sign Up for Service
Is this account for an individual or a business?*

IndividualBusiness

Business Name*
Service Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email*
example@example.com
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Phone Type*

HomeWorkMobile
Secondary Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Secondary Phone Type

HomeWorkMobile
Is the mailing address different than the service address?*

YesNo

First Name*
Last Name*
Name*

First NameLast Name
Service Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email*
example@example.com
Primary Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Phone Type*

HomeWorkMobile
Secondary Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Secondary Phone Type

HomeWorkMobile
Is the mailing address different than the service address?*

YesNo

Mailing Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Is there a co-applicant?*

YesNo

Co-Applicant First Name*
Last Name*
I authorize Benton REA to perform a soft credit check using my provided information. This soft credit check will be used to determine if a deposit is required to establish service. A Member Experience Representative will contact me by phone to securely collect my Social Security Number in order to complete the soft credit check.

Initial here to provide express consent for the soft credit check: Initials*
Co-Applicant Name*

First NameLast Name
Co- Applicant Signature*
Co- Applicant Signature
Signature
Date

MonthDayYear
Date

Type of Service (Check all that apply)*

ResidenceShopCommercialIrrigationIndustrialSeasonal/Cabin
Meter Number
Do you own or rent?*

OwnRent
Desired Connection Date*

MonthDayYear
Date

Deposit Determination

Required
I authorize Benton REA to perform a soft credit check using my provided information. This soft credit check will be used to determine if a deposit is required to establish service. A Member Experience Representative will contact me by phone to securely collect my Social Security Number in order to complete the soft credit check.

Initial here to provide express consent for the soft credit check: Initials*
No deposit is required if you provide a letter of credit from your most recent electric utility, showing no more than two late payments in the past 12 months. If you do not provide a qualifying letter of credit, a security deposit will be required before your service can be connected. Important: We can start your service application; however, we cannot move forward with scheduling your connection until we have received either your letter of credit or your deposit. If we have not received your letter of credit or deposit by the time service is requested, your connection date will be delayed until the requirement is met.*

Letter of CreditDeposit
Letter of Credit Upload

Cancelof
Ownership Credits
As a member-owner, you may be eligible to receive Ownership Credits from Benton REA in the future. Credits are typically issued as a check once they reach a minimum amount, but checks are not guaranteed each year. To avoid minimum requirements, you can choose to have your credits applied directly to your active account. Select one:*

Apply Ownership Credits to my Account (Recommended)Issue a check (Only issued if minimum is met)Donate to Power to Care (Community Assistance Program)

The undersigned hereby applies for membership in the Benton Rural Electric Association, Prosser, Washington, and agrees to purchase from the cooperative electric energy as specified in the Bylaws and to pay therefore at rates which shall be determined by the Board of Trustees. The Applicant(s) agrees to comply with the rules and regulations as set forth in the Articles of Incorporation and the Bylaws of the cooperative, and amendments thereto, and all rules and regulations adopted and as may from time to time be adopted by the Board of Trustees of Benton REA. In the case of a natural person, the Applicant(s) attests to being of legal age of 18 years or older. The Benton Rural Electric Association requires that you certify your application by submitting an electronic signature. By typing your full name below and clicking “Sign Up For Service”, you certify that all the information in the application and your signature is accurate and true. You agree, in order for us to service your account or to collect any amounts you may owe, we may contact you by telephone at any telephone number associated with your account, including wireless telephone numbers, which could result in charges to you. We may also contact you by sending text messages or emails, using any email address you provide us with. Methods of contact may include using pre-recorded or artificial voice messages and/or the use of an automatic dialing device, as applicable. I/We have read this disclosure and agree that Benton REA may contact me/us as described above.
Signature*
The undersigned hereby applies for membership in the Benton Rural Electric Association, Prosser, Washington, and agrees to purchase from the cooperative electric energy as specified in the Bylaws and to pay therefore at rates which shall be determined by the Board of Trustees. The Applicant(s) agrees to comply with the rules and regulations as set forth in the Articles of Incorporation and the Bylaws of the cooperative, and amendments thereto, and all rules and regulations adopted and as may from time to time be adopted by the Board of Trustees of Benton REA. In the case of a natural person, the Applicant(s) attests to being of legal age of 18 years or older. The Benton Rural Electric Association requires that you certify your application by submitting an electronic signature. By typing your full name below and clicking “Sign Up For Service”, you certify that all the information in the application and your signature is accurate and true.*
Date*

MonthDayYear
Date
Should be Empty:

Sign Up for Service

Deposit Determination

Ownership Credits