Randolph Electric Membership Corporation*

Welcome to Randolph EMC’s On-Line Application for Electric Service

This service is designed for new members who are moving into a residence with existing electric service. If you are establishing service at a location that does not have electric power in place, such as new construction, please contact Randolph EMC 1.800.672.8212 toll-free.

In addition, if you require service within the next 2 days (excluding weekends and holidays), we ask you to contact us at the telephone numbers listed above.

New applicants are required to pay a $5.00 membership and a deposit to receive electric service. The deposit requirement can be waived if we receive one of the following:

Verification of good credit through a credit check.
Guarantor letter for your new account from an eligible REMC member
If a deposit is collected for your new account, it will be held a minimum of 12 months (unless service is terminated prior to then). Deposits are released once your bill has been paid on time for a minimum of 12 months with 2 or fewer delinquent bills. Membership fee and deposits are refunded as a credit against your bill if power is disconnected and you are no longer a member of Randolph EMC.

At the end of the application form you will have an opportunity to provide additional information about your request or to ask other questions regarding your new service. Please print out a copy of your completed application form for your records.

	Indicates a required field. Customer Information:*
	*First Name:
	*Last Name:
	Middle Initial:
	Suffix:
	Day Time Phone:
	Evening Phone:
	*Social Security Number:
	*Email Address:
	*Requested Service Date:
	Location of Service:
	*Address 1:
	Address 2:
	*City:
	*State:
	*Zip:
	Billing Address: (If different from service address)
	First Name:
	Last Name:
	Address 1:
	Address 2:
	City:
	State:
	Zip: