Application for New Service

To Begin New Residential Service:
New residential members will need to fill out and submit the following Application for Membership form as well as email a copy your driver's license and Social Security card as proof of identification. The deposit for the new residential service is $250, and must be paid prior to establishing service. There is an additional $35 non-refundable service charge and a $5 membership fee.

To Begin New Commercial Service:
New Commercial members must also fill out and submit the following Application for Membership form as well as email a copy your driver's license and Social Security card as proof of identification. Deposits for commercial service are based on an estimated three months usage at the location in question, with a minimum deposit of $500. In lieu of the required deposits, commercial account holders may choose to submit an irrevocable letter of credit form their financial institution, or a surety bond from their insurance company.

Note: All fields with the asterisk (*) are required.

Today's Date:  
Date Service is Desired:  *  
Type of Request:   *
First & Middle Name:   *
Last Name:   *
Social Security Number:-  -   
*Please exclude the dashes when entering DL#*
Driver's License Number:
 *
License State:  
Birth Date:    
Employer:  
Maiden Name if Applicable:  
Marital Status:  *
Employer:  
Employer's Telephone Number:  
Date of Birth:  *

Mailing 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):   *
Meter Number (if applicable):  
If applicable, directions to new construction:  
E-mail:  *
Confirm E-mail:  *
Home Phone:-  -    *
Cell Phone:-  -    *
Business Phone:-  -     
Co Applicant Driver's License:  
Co Applicant License State:  
Co Applicant Birth Date:    
Co Applicant Employer:  
Are you applying for a Prepaid Electric Service? If so, the form will need to be downloaded, filled out and faxed back to WFEC at 850.547.9521.  *
If there is a yard light(s) associated with this account, would you like to have them connected? (Y/N) If so, the form will need to be downloaded, filled out and faxed back to WFEC at 850.547.9521.  *

Online Access:

As one of our services, we provide an online application for viewing and paying bills. Please specify an Internet Password and Password Hint at this time. Please note that the Internet Password must be at least 4 characters in length.

Internet Password:  *
Confirm Internet Password:  
Password Hint:

Previous or Existing Service:
Have you ever had service with WFEC before? If so, enter account number.
    
Account Number:

Description of Fees:
Fees will be required to establish service, in addition to any applicable cost in aid of construction for new services. You will receive an email once your application has been processed including the total amount due before service can be connected.

Please list other adults that will be residing at this location:  *
Emergency contact name that will not be residing at this location:  *
Relationship to applicant:  *
Emergency contact telephone number:  *
Landlord's Name (if applicable):  
Landlord's Telephone Number (if applicable):  
Do you rent or own this location?  
Preferred Billing Method:   *
Preferred Delinquent Method:   *
 
**Important, please read and accept**

By submitting this application request I confirm that I have read and understand and agree to the Terms and Conditions outlined in the membership agreement of WFEC.