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New Service Application

Please complete this form to apply for NEW service only. If you are currently a Kankakee Valley REMC Member and wish to transfer your current service click here. If you wish to disconnect your Kankakee Valley REMC service AND are not transferring service to another Kankakee Valley REMC location, click here. All requests received after 1 p.m. will be processed the next business day.

Note: All fields with the asterisk (*) are required. Incomplete applications will not be processed. Information on this application will be used for the purpose of a credit check through Online Utility Exchange. Depending upon the results of your credit check, you may be required to pay a deposit in full, prior to electric service being connected.

*(Required Field)

Applicant Information:

Desired Form of Membership:

*Name:

Mrs

Miss

Business Name (if applicable):

Tax ID #:

*Last 4 of Social Security Number:

[* see notes below]

*Home Phone:

*Work Phone:

Cell Phone:

*Current Employer:

*Years of Employment:

*Employer Phone:

Spouse Information:

Spouse Name:

Last 4 of Spouse Social Security Number:

[* see notes below]

Spouse Home Phone:

Spouse Work Phone:

Spouse Cell Phone:

Spouse DOB:

Address Information:

*Address:

*City:

*State:

*Zip:

Mailing Address is different than Service Address:

Yes

Address:

City:

State:

Zip:

Service Information:

*Requested by:

*Service Start Date (mm/dd/yy):

Note: Please allow up to three (3) business days to process your request.

Type of Establishment:

Subdivision Name:

Lot:

Landlord's Name:

Landlord's Address:

Landlord's Phone:

*Members are automatically enrolled in Operation Roundup: Learn about Operation Roundup here.

I would like to pay my bill by:

Mail/Office

Bank Draft

Credit Card

Click here for Bank Draft Form or Credit Card Form. Complete and mail the appropriate form to our office if you select one of those payment methods

Notes:

A one time $35.00 membership fee is required to receive service from Kankakee Valley REMC.

A security deposit may also be required – based on a routine credit check. Your Social Security number is required for this credit check and serves as proof of identification to safeguard your account information. Due to the sensitive nature of this information, we do not accept your Social Security number through our website. One of our Customer Service Representatives will contact you at the phone number you provide to obtain this information. If you prefer not to provide your Social Security number, the maximum security deposit of $350.00 will be required before service is connected.

A Kankakee Valley REMC Customer Service Representative will also contact you should there be any additional questions in establishing your account. You will be sent information that will need to be completed and returned to our office, along with any fees, within 14 days of the connection date.

YOU WILL RECEIVE 14 DAYS TEMPORARY SERVICE ONLY. ALL FORMS AND FEES DUE MUST BE RECEIVED IN OUR OFFICE WITHIN THE 14 DAY PERIOD OR THE ELECTRIC SERVICE WILL BE TERMINATED.

IMPORTANT - READ CAREFULLY: The Membership Application requires that you agree to be bound by the Kankakee Valley REMC Rules & Regulations that appear on this page. Your agreement is a condition of membership and creates a legal agreement between you (a single entity or person hereinafter referred to as “Member”) and Kankakee Valley REMC (“Kankakee Valley REMC or Co-op”) that governs the terms of delivery of your electric service. By selecting “I Agree” below or if you otherwise receive electric service from Kankakee Valley, you agree to be bound by the Kankakee Valley Rules & Regulations. If you do not agree to the Rules & Regulations, you may not be connected to Kankakee Valley’s system or you may be disconnected.

I have read and agree to the Kankakee Valley Rules & Regulations