Membership Application

Below is an online application webform that can be filled out and submitted electronically in order to set up your membership with Consumers Energy.

You can also click the button below to open a fillable PDF Membership Application form for Consumers Energy. This document will need to be printed in order for proper signing of the document. If you have any questions regarding this process please call the office at 1-800-696-6552 or 641-752-1593.

FOR MEMBERS OF CONSUMERS ENERGY COOPERATIVE OF IOWA ONLY!!

Membership Application - Printable PDF

FOR MEMBERS OF CONSUMERS ENERGY COOPERATIVE OF IOWA ONLY!!

Please read the following and fill out form below.

The undersigned (hereafter called “Applicant”) hereby applies for membership in, and agrees to purchase electricity from Consumers Energy (hereafter called “Cooperative”), upon the following terms and conditions:

The Applicant will sign this application and if accepted by the Cooperative, will constitute the Applicant’s membership in the Cooperative.
The Applicant will, when electricity becomes available, purchase from the Cooperative all electricity used on the premises described above and will pay on a monthly basis at the rates and prices which will be fixed by the Board of Directors of the Cooperative.
The Applicant will cause the premises to be wired in accordance with specifications approved by the Cooperative and in accordance with all applicable codes.
The Applicant will comply with and be bound by the provisions of the Articles of Incorporation and By-Laws of the Cooperative, and such rules and regulations as may, from time to time, be adopted by the Cooperative.
The Applicant grants to the Cooperative an easement over, under, and upon the property of the Applicant for the purpose of extending the Cooperative’s electric distribution lines to the premises of Applicant.
The Applicant agrees to provide two days’ notice prior to vacating any property served by the Cooperative. Such notice may be either verbal or written. Until such notice is given, the Applicant acknowledges and agrees that they are responsible for all electric usage.
If the property for which service is being provided by the Cooperative is or becomes a rental property, the Applicant must notify the landlord and Cooperative of the date that the property will be vacated.

Acceptance of this application and the furnishing of electricity by the Cooperative to the Applicant will constitute an acceptance of the above offer to purchase electricity, and be a contract between the Applicant and the Cooperative that shall continue in force from the date service is first furnished to the Applicant by the Cooperative and thereafter until canceled by notice given by either party to each other.

Requested Connect Date

Consumers Energy requires a minimum of two (2) business days to complete requests for service.

Main Applicant

Name - Head of Household or Business Name

Email Address

Driver's License Number

Date of Birth

Primary Phone

Secondary Phone

Place of Employment

Do you have a co-applicant?

Yes

No

Co-Applicant

Name - Spouse/Joint Member/Co-Applicant

Email Address for Joint Member/Co-Applicant

Co-applicant Drivers License

Co-applicant Date of Birth

Primary Phone

Place of Employment for Joint Member/Co-Applicant

Service Location Information

Service Address

Address

City/Town

State/Province

ZIP/Postal Code

Mailing Address (if different than Service Address)

Address

City/Town

State/Province

ZIP/Postal Code

Landlord/Owner Information

Landlord/Owner - Name

Landlord/Owner - Email

Landlord/Owner - Phone

Address

City/Town

State/Province

ZIP/Postal Code

Names of All Adults Residing at Service Address

Signatures

Signature of Applicant/Business Owner

Sign above

Signature of Co-Applicant

Sign above

Signature Disclosure

For the purpose of Consumers Energy online forms, when the word "signature" "signature of applicant" or "signature of co-applicant" appears, a typed, legal name is an acceptable substitute. As long as the complete, legal name appears in each blank for which a signature was requested, the form is accurate and binding (pending accurate completion of all other form sections). It is not necessary to print and sign the form if users plan on submitting the form electronically. I agree that my electronic signature on this agreement/document has the same effect as a signature signed in ink.

Applicant Protection

TO PROTECT FROM IDENTITY THEFT, ONLY APPLICANTS WHOSE SIGNATURES ARE PROVIDED ABOVE WILL BE GIVEN INFORMATION REGARDING THE ACCOUNT UPON VERIFICATION OF IDENTITY BY A COOPERATIVE EMPLOYEE.