Choptank Electric Cooperative - Member Information
 
MEMBER INFORMATION & CUSTOMER CHOICE



 
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Application for New Service


(for new construction only)

To sign up for a new Choptank Electric account, please fill in the fields below; required fields are indicated in red.

Date:


Customer First Name:


Customer Last Name:


E-Mail Address:


Phone Number:


Present Mailing Address:




City Name:
State:
Zipcode:



Address of Property to be Served:

911 Address:


City Name:
State:
Zipcode:


Subdivision and Lot Number:


County:
Tax Map:
Parcel:



Service Size Requested:

200 Amp 320 Amp 400 Amp (Bolt-In Meter)       Other
Single Phase Three Phase Voltage

Type of Heating:   Heat Pump Electric Baseboard Gas Other

Type of Water Heater:   Electric Gas

Central Air:   Yes No

General Contractor:   Phone:  

Electrical Contractor:   Phone:  

Construction Start Date:  

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Choptank Electric Cooperative, Inc., P.O. Box 430, Denton MD 21629 Toll Free: 877-892-0001


Copyright © 1997-2014, Choptank Electric Cooperative Inc., All Rights Reserved