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Home
About Us
- Contact
- Districts
- Staff
Our Services
Resources
Pay My Bill

New Service Form

Service Type*
- Turn On Electric
- New Construction
- Fiber Services (Internet, Television, and Telephone)
- Fiber Services Only (Choose this option if you already have electric services with us.)
Name*
First Middle Initial Last
Email Address*
Phone*
Alternate Phone
Driver License Number*
Driver License State*
State
Upload scan or photo of driver license*
Accepted file types: doc, docx, pdf, jpg, jpeg, gif, tiff, png, Max. file size: 100 MB.
Date of Birth*
Month
Day
Year
Social Security Number*
Service Address*
Street Address Address Line 2 City State ZIP Code
Mailing Address (if different)
Street Address Address Line 2 City State ZIP Code
Employer*
Employer Phone Number*
Add a co-applicant?*
- Yes
- No
Co-applicant Name*
First Last
Co-applicant Social Security Number*
Co-applicant Date of Birth*
MM slash DD slash YYYY
Co-applicants State and Driver License Number*
List the names of any adults over the age of 18 years old living in household:*
Have you ever had service with North Alabama Electric Cooperative?*
- Yes
- No
Previous Service Address*
Street Address Address Line 2 City State ZIP Code
Renting or purchasing?
- Renting
- Purchasing
Residence Type:*
- House
- Mobile Home
Additional Notes:
*If you are renting or leasing you will need to fax or email rental/or lease agreement with Landlords name, address, and contact phone number, along with a copy of your picture identification. If you are purchasing a property, we will need the warranty deed or purchase agreement along with a copy of your driver's license.
**If you are renting and want to add our Fiber Services you will need permission from your Landlord in the form of a letter.
Upload rental or purchase agreement*
Drop files here or

Accepted file types: doc, docx, rtf, txt, odt, pdf, jpg, jpeg, gif, tiff, png, Max. file size: 100 MB.
Do you agree to the following terms and do you consent to sign this form electronically?*
- Yes
Electronic Signature (Full Name)*
By submitting this request, I, the above named individual (hereinafter called applicant) hereby apply for membership in and agree to purchase all electric energy for the requirements of the premises for which this application is made from North Alabama Electric Cooperative (hereinafter called Cooperative). The information given herein is to my knowledge correct. A soft credit check will be performed to determine the amount of your deposit, and we will contact you with the amount due. Once the membership and deposit has been paid by use of kiosk, online, night drop, or over the phone an order to connect your services will be generated. Once the order has been submitted, it will be connected the next business day if possible.
Electric Account Number*
What services are you interested in?*
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Contact Info

Address:
41103 U.S. Hwy 72 Stevenson, AL 35772
Business hours:
Monday - Friday, 7:30 a.m. - 4:30 p.m
Phone:
Electric: 256-437-2281 or 800-572-2900
After Hours: 256-437-1100 or 800-572-2900
Fiber: 256-437-5000
Fiber After hours: 256-437-5000 option 1

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