To establish gas service with Fuel Georgia, please complete the below Application.  If you have any questions, or prefer to apply over the phone, contact our office at (678) 774-6010 or (833) 903-FUEL (Toll-Free) or send an email to info@fuelgeorgia.com.

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

Today's Date:  
Date Service is Desired:  *  
Type of Request:   *
Applicant First Name:   *
Applicant Last Name:   *
Applicant Middle Initial:  
SSN:--  *
If you have Electric service with Central Georgia EMC, 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:  
City, State and Zip Code:   *
E-mail:  *
Confirm E-mail:  *
Telephone Number:--   *
Cell Phone:--   *
Preferred Method of Contact:
(indicate phone, text or email)		  *

Online Account Access:
We offer a customer portal and mobile app for access to your payment options, account management and easy access to your ebill. If you would like to access your account online, please create a password and password hint below. For security purposes, a minimum password length of 10 characters and a combination of uppercase letters, lowercase letters, numbers, and symbols (!@#$%^&*) is required.

IMPORTANT NOTE: If you already have online access set up for your electric account, please disregard this section as the same login access will be used to manage both your electric and gas accounts.
Internet Password:  
Confirm Internet Password:  
Password Hint:

Have you ever had service with Central Georgia EMC or Fuel Georgia before?    
Account Number:

Natural Gas:
In the "Type of Service" field provided below, please indicate
Marketer Switch
Meter Turn On/Existing Service or
Meter Set/New Service

In the "Select a Fuel Georgia Rate Plan" field provided below, please indicate
6-Month Fixed Rate
12-Month Fixed Rate
24-Month Fixed Rate or
Variable Rate

Type of Service:  *
Select a Fuel Georgia Rate Plan:  *
Do you Own or Rent this location:   *
Preferred Contact and Billing Method:  
 
Check here to agree to the following terms:
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:     *