Kenergy Corp

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Apply for Service For New Construction

* Required Field

* Applicant Name:
(Last,First,MI):

* Applicant - Last 4 of SSN
(If commercial, Federal ID#)

Co-Applicant Name:
(Last,First,MI):

Co-Applicant - Last 4 of SSN

Current Mailing Address:

* Address 1:

Address 2:

* City:

* State:

Zip:

* Primary Phone:

Work Phone:

Cell Phone:

* Email:

Has this facility had an electrical inspection?

If yes,

Name of Inspector:

Date of Inspection:

* Type of Service Requested:
* Amp. Service Required:	100 Amp 200 Amp Other:
Type of Heat:
Heating system size:
Type of Air:
Air Conditioning Size in Tons:
Square Footage:
Service Address:
County:
Water District:
Description of site:

* Directions to the site, including subdivision, lot# and any other information helpful in locating the site:
Additional Comments

A $5 membership fee is required to receive service from Kenergy Corp.

A security deposit of $190 or higher may also be required - based on a routine credit check.

The construction of your service may require that you share in a portion of the cost associated with the construction.