To establish electric service with Central Georgia EMC, please complete the below Application.  If you have any questions, or prefer to apply over the phone, contact our office at 770-775-7857 or 800-222-4877 or send an email to csr@cgemc.com.

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

Today's Date:  
Date Service is Desired:  *  
Type of Request:   *
*Select both boxes to have both services connected
Application Type:      *
Applicant First Name:   *
Applicant Last Name:   *
Applicant Middle Initial:  
SSN:--  *
Nationality  *
If establishing both Electric and Natural Gas services, do you want to combine your bill to an Invoice bill? (Yes/No)  

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

Service Address:
Service Address:  
Service Type (Construction Required or Existing Service):   *
If applicable, directions to new construction:  
E-mail:  *
Confirm E-mail:  *
Telephone Number:--   *
Cell Phone:--   *
Spouse or Co Member Name: 
Spouse or Co Member SSN:-- 
Relative or Emergency Contact:  
Relationship:  
Relative or Emergency Contact Telephone:  

Online Account Access:
As one of our services, we provide an online application for viewing and paying bills.
If you would like to use this service, please specify an Internet Password and Password Hint at this time.
Internet Password:  
Confirm Internet Password:  
Password Hint:

Have you ever had service with us before?    
Account Number:


Type of Service: (Natural Gas only)  
Select a Fuel Georgia Rate Plan: (Natural Gas only)  
Is there an outside security light at this location? (Yes/No)  
If yes, do you want to continue outside security light service? (Yes/No)  
Do you Own or Rent this location:   *
Would you like to participate in Operation RoundUp®? (Electric Only)   *
Preferred Contact and Billing Method:  
 
Check here to agree to the following terms:
Electric Service: 
1. To comply with and be bound by the provisions of the Articles of Incorporation, Bylaws, and such rules and regulations and policies as may be adopted from time to time by the Board of Directors of CGEMC; and when requested by CGEMC to execute and deliver easements or right of way in accordance with such reasonable terms and conditions as CGEMC shall require across my (our) property for the furnishing of electric service to my (our) premises or to provide service to other premises. 
2. To indemnify, defend, and hold harmless CGEMC against all claims, demands, cost or expenses for losses, damages, or injuries to persons or property in any manner directly or indirectly arising from, connected with, or growing out of the transmission or use of electrical current at or on my (our) side of the meter, or arising solely by virtue of CGEMC providing electrical service to my (our) premises or arising from electric service to a manufactured or mobile home with the meter base mounted on the home. I (we) understand that CGEMC does not assume any responsibility for wiring beyond the meter or any responsibility for inspection of wiring beyond the meter. 
3. All past due accounts which are deemed uncollectible will be turned over to Central Georgia EMC’s contract collection agency, court, or to Central Georgia EMC’s attorney for collection with full authority to make payment demands for the cooperative. All costs of collection will be added to the customer’s past due account and will be paid by the customer, including court costs, reasonable attorney fees, and a reasonable collection agency fee of 35% of the amount of the past due account for accounts that are turned over to a collection agency. 
4. By submitting this application request, I authorize Central Georgia EMC to perform the necessary credit check to determine the security deposit requirement.

Gas Service:
1. By submitting this application request, I authorize Fuel Georgia to perform the necessary credit check to determine my eligibility for natural gas service and the security deposit requirement.
2. As a consumer, I shall have a three-day right of rescission following receipt of my disclosure statement, at the time of initiating service, or when informed of a change in terms or conditions.  You, the consumer, may rescind by telephone, in writing, or electronically by contacting the marketer, Fuel Georgia. You will receive verification of recission through your Preferred Method of Communication. 
I understand that checking this box and typing my name in the field provided below is my electronic signature.
  Applicant Name:     *