Electric Service Agreement:
Please provide the information requested on the next pages, sign the Electric Service Agreement and immediately return the completed form to Northeast Power, including any security deposits or other payment due. Failure to do so will result in delay of service or disconnection of service.

Northeast Power collects only customer information required to effectively manage its operations and customer relationships. No information defined by law as 'personally identifying data' is provided to any party outside Northeast Power other than Northeast’s lawful agents.

Before requesting service, please click here to read the policy on billing and collection procedures for energy bills, then return here to fill out the on-line application.

Customer Information:

*Please select "Joint" from the dropdown if there are two applicants.

(Only those listed on the application will be able to call in for information on the account)

Today's Date:  
Date Service is Desired:    
Type of Request:  
Applicant One:
First Name:		   *
Last Name:   *
List person(s) who can inquire and/ or have permission to do the following  
Pay with a debit/credit card or echeck in applicants name:
(yes or no)		  
Make changes to the account:
(yes or no)		  
Request work to done at the service location:
*even if there is a charge (yes or no)		  
Existing Service:
Have you ever had service with us before?		  *

Billing Information:

Billing Address:
Please enter the address where bills should be sent:

Street Address/P.O. Box:  *
City:  *
State:  *
Zip Code:   *

Service Address:
Please enter the street address where service is required:

Service Address:   *
Service Type (Construction Required or Existing Service):   *
Service Classification/Comments:
Indicate Residential Only, Non Residential Farm, Commerical, Pump/Seasonal Service, Farm and Residential or Large Power		   *
E-mail:  *
Confirm E-mail:  *
Phone #:--   *
Cell Phone:--   *
Cell Phone Provider:  *
Personal Call:
Northeast Power will make a personal phone call to avoid scheduling a collection trip. There is a $5.00 charge for this call Please indicate if you would like to receive this personal phone call.
(yes or no)		  *


Note: Opting out of the personal phone collection call will not prevent you from receiving automated collection or outage notifications.

Online Access:
As one of our services, we offer an online system for paying bills with a credit card.  If you would like to use this system, please specify an Internet Password and Password Hint in the fields provided below:    

Internet Password:  
Confirm Internet Password:  
Password Hint:

Payment Options:

Standard Option: (Required for the Standard Option and must be provided immediately upon signing up for electric service.)

  Security Deposit to be determined by Management (Policy 11-07)

An existing customer with excellent credit: (Maximum of 1 penalty in last 12 months)

Letter of credit reference to be supplied by previous power supplier (Maximum of 1 penalty in last 12 months)

All billings guaranteed by landowners or cosigner pursuant to Electric Service Agreement as herein after provided.*

*If you wish to have a Guarantee by Landowner or Cosigner, please click here to download and fill out a copy of our printable version of this form. If you are choosing this option, a paper application is required.

PrePay Option: (Limitations and restrictions may apply. Ask billing clerk for specifics) The records of either an active email address or cell phone number must always be on file and kept current to participate in the PrePay option.  For more information please read Rules of PrePay Service


Confirm Payment Option:
Indicate Pay Deposit, Letter of Credit, Guarantor, or Prepay		  
Occupancy:
Landlord Name:		  
Street, City, State and Zip:  
Phone #:  
Cell #:  
Do you rent or own?   *
Operation Roundup:
To opt out please select 'no' from the drop down menu. See more information below.		   *
 
I have read and understand the terms and conditions.
I understand that checking this box and typing my name in the field provided below is my electronic signature.
  Applicant Name:     *