To establish electric service with Palmetto Electric Cooperative, please complete the Application below. To ensure your application process is not delayed, when choosing the Type of Request please adhere to the following: If you are applying for service to a house that has an existing meter please fill out the Residential application. Commercial locations should fill out the Commercial application. If you are building a new home or remodeling an existing home please fill out the New Construction application found on the main page of the member payment portal. If you have any questions, or prefer to apply over the phone, contact our office at 1-800-922-5551 or send an email to csr@palmetto.coop

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

Current Date:  
Date Service is Desired:  *  
Type of Request:   *
Applicant Information:
First Name:		   *
Last Name:   *
Middle Initial:  
Social Security #:--  *

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

Service Address:
Physical Address

Service Address:   *
Unit/Apartment #:  
E-mail:  *
Confirm E-mail:  *
Primary Phone:--   *
Cell Phone:--   *
Business Phone:--   
Spouse Information for Joint Membership:
Spouse Name:		 
Social Security #:-- 

Note: Click here to see Palmetto's Joint Membership Requirements, Section 3.

Online Access:
As one of our services, we offer an online application for viewing and paying bills. If you would like to use this service, you can specify an Internet Password and Password Hint at this time. For security purposes, please specify a Password that is at least 4 characters in length.
Internet Password:  
Confirm Internet Password:  
Password Hint:

Deposit Information:
Residential:
In addition to the fees shown below, a deposit may also be required for service to be connected. The deposit amount is based on risk factor analysis. When your account is created, you will receive an email with the total amount due on your new account, including the deposit amount and the Membership Fee, if applicable. The deposit is due before electric service will be activated.

Commercial:
In addition to the fees shown below, a deposit will be required. The deposit amount is based on a two month average bill. When your account is created, you will receive an email with the total amount due on your new account.

Membership Fee:  
Processing Fee:  

Previously had or currently have service with Palmetto Electric Cooperative?
(yes or no)		  *
If yes, what location?  
How would you like to receive your electric bill?   *
 
Signing below confirms that I have read and understand the Bylaws outlined in the Members Manual of Palmetto Electric Cooperative.
I understand that checking this box and typing my name in the field provided below is my electronic signature.
  Applicant Signature:     *