Please complete this form to apply for electric service. Service requests are processed during normal business hours (Monday – Friday, 8am – 5pm). If you have any questions regarding service, please feel free to contact our office (855) 277-8372.

Note:  All fields with the asterisk (*) are required. Incomplete applications will not be processed.


Today's Date:  
Date Service is Desired:  *  
Type of Request:   *
Account First Name:   *
Account Last Name:   *
SSN:--  *
Driver's License #:  
License State:  
Birth Date:    

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 physical address where service is required:
Service Address:   *
Comments:  
E-mail:  *
Confirm E-mail:  *
Home Phone:--   *
Cell Phone:--  
Co Applicant Name: 
Co Applicant SSN:-- 

Online Account Access:
As one of our services, we offer a Portal for online bill payment and account management. If you wish to use this service, please create a password below. *Passwords must be a combination of letters and numbers.
Internet Password:  
Confirm Internet Password:  
Password Hint:

Service History:
Do you currently or have you previously had service with Pearl River Valley EPA?    
Account Number:
Fee & Deposit Information:

Pearl River Valley Electric Power Association has established its member fees and charges based on the reasonable and customary standard for our industry and local area.  Details here.

Membership Fee - $5.00 - required to establish a member account, regardless of the number of meters assigned to the account. Upon termination of service, the fee is applied to the final billing or if the account is paid in full, the fee is refundable. (Membership fees are not transferable from one person to another).

Security Deposit - $0—300.00 - Deposits are determined by credit scores and may be waived if a member has a good credit rating. Commercial deposits dependent on service size and may require a surety bond. The deposit earns yearly interest and shall be credited to account when service is terminated.

$100.00 - minimum deposit required if construction is necessary for new service to a mobile home.

Connection Fee - $45.00 - a non-refundable fee charged when connecting new service or transferring service to a different location in PRVEPA’s service area. This fee is also charged for installing a new security light.

When your account is officially created in our system, you will receive a new account information email which will include a total balance due on your new account, including deposit (if applicable).

Membership Fee:  
Connection Fee  

Electronic Signature:
Please type your name in the field area provided. I understand this is my electronic signature:		  *
Please type date in the field provided (MM/DD/YYYY).  *
Please select your preferred Billing Method:   *
 
By checking this box and place my name in the electronic signature area provided below, I, the undersigned (hereinafter called the "APPLICANT") hereby applies for membership in, and agrees to purchase electric power and energy from PEARL RIVER VALLEY ELECTRIC POWER ASSOCIATION (hereinafter called the "ASSOCIATION"). I have read, understand and agree to the terms and conditions of the membership application service agreement.
I understand that checking this box and typing my name in the field provided below is my electronic signature.
  Applicant Name:     *