Prepaid Electric Service Agreement

Name(Required)
Second Applicant Name
Service Address(Required)

Statement of Agreement Conditions:

The undersigned, (hereinafter called the "Member") hereby applies for participation in the Prepaid Electric Service Program offered to active members of Adams-Columbia Electric Cooperative (hereinafter called the "Cooperative"), and agrees with the Cooperative to the following terms and conditions: (Initial after each of the following statements):
Type in your initials. If there is a second applicant, please separate the initials with a comma.
Type in your initials. If there is a second applicant, please separate the initials with a comma.
Type in your initials. If there is a second applicant, please separate the initials with a comma.
Type in your initials. If there is a second applicant, please separate the initials with a comma.
Type in your initials. If there is a second applicant, please separate the initials with a comma.
Type in your initials. If there is a second applicant, please separate the initials with a comma.
Type in your initials. If there is a second applicant, please separate the initials with a comma.
Type in your initials. If there is a second applicant, please separate the initials with a comma.
Type in your initials. If there is a second applicant, please separate the initials with a comma.
Type in your initials. If there is a second applicant, please separate the initials with a comma.
Type in your initials. If there is a second applicant, please separate the initials with a comma.
Type in your initials. If there is a second applicant, please separate the initials with a comma.
Type in your initials. If there is a second applicant, please separate the initials with a comma.
Type in your initials. If there is a second applicant, please separate the initials with a comma.
Type in your initials. If there is a second applicant, please separate the initials with a comma.
Type in your initials. If there is a second applicant, please separate the initials with a comma.
Type in your initials. If there is a second applicant, please separate the initials with a comma.
Type in your initials. If there is a second applicant, please separate the initials with a comma.
By electronically signing, you agree to the terms and conditions of this prepaid electric service agreement.
By electronically signing, you agree to the terms and conditions of this prepaid electric service agreement.
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