New Account Application

First Name*Middle NameLast Name*Social Security Number*Date of Birth*Valid State Issued Driver's License or ID*

Upload File

Max file size 10MB.

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Do you have a co-applicant?*

YesNo

Co-Applicant Details

Co-Applicant First NameCo-Applicant Middle NameCo-Applicant Last NameCo-Applicant Social Security NumberCo-Applicant Date of BirthCo-Applicant Valid State Issued Driver's License or ID*

Upload File

Max file size 10MB.

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Billing Address

Address*Address 2City/Town*State*ZIP/Postal Code*

Service (911) Address

Is your service address the same as your billing address?

YesNo

Service Address

AddressAddress 2City/TownStateZIP/Postal Code

More Details

Do you agree to a soft utility credit check?

YesNo

Structure Status

Existing StructureUnder Construction

Cell PhoneEmail Address*

Date Service Requested*

Square Feet*NotesProperty Status

OwnRent/Landlord

Landlord Details

Landlord NameLease Management CompanyContact Number

The information you submit will be used to set up your account, to check your credit history, and to determine the amount of any required security deposit. We will contact you via email the next business day with your account information and fees.

We do not share your contact information with any other organization for any purpose not related to the business of the cooperative.

Read our Privacy Statement

Please visit our website for more information on Grayson-Collin Electric Cooperative or call our member service department at 903-482-7100.

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