Please complete this application to apply for electric service. Once you have submitted this application, please provide a front and back photocopy of your government issued photo ID to otecmemberservices@otec.coop. Upon receiving your government issued photo ID, we will process your request. Service requests are processed during normal business hours (Monday – Friday, 8am – 5pm). If you have any questions regarding service, please feel free to contact our office 541.523.3616.

Note: All fields with the asterisk (*) are required. Incomplete applications will not be processed.

Click here for more information about our Prepay Metering program and its advantages.

Today's Date:  
Date Service is Desired:  *  
Type of Request:   *
Applicant Information:
First Name:		   *
Last Name:   *
Middle Initial:  
Social Security Number:--  *
Government Issued ID #:  *
Issued State:  
Birth Date:  *  
Employer:  
Cell Phone Carrier:  *

Mailing Address:
Please provide the address where bills should be sent.
Street Address/P.O. Box:  *
City:  *
State:  *
Zip Code:   *

Service Address:
Please provide entire service address, including Apartment # and City, incomplete applications will be delayed in processing
Service Address:   *
City, State and Zip Code; Additional Comments:   *
E-mail:  *
Confirm E-mail:  *
Home Phone:--   *
Cell Phone:--  
Work Phone:--   
Spouse Information:
*must be married to establish a joint account
Name:		 
Social Security Number:-- 
Government Issued ID #:  
Issued State:  
Birth Date:    
Employer:  
Email Address:  
Phone Number (if different from applicant):  
Please have your spouse type their name in the field area for this to be a joint account; this serves as your electronic signature agreeing to the terms below:  
Cell Phone Carrier:  

Online Access:
We offer a portal for online bill payment and account management. To easily manage your account through our online portal, please create a password and hint. Please note passwords must be a combination of letters and numbers.
Internet Password:  
Confirm Internet Password:  
Password Hint:

Existing/Previous Service:
Have you had service with us before?
*enter only numbers before dash into the account number field below.  Example "12345-001" would be "12345"    
Account Number:


Would you like this to be a Prepay Account?
(indicate yes or no)		  *
Please indicate if location is a Rental or Seasonal Home/Business:  
Is location all Electric?  *
Additional/Emergency Contact Name:  
Additional/Emergency Contact Phone:  
Do you have a child or children in the house under 5 years old?
If yes, Would you like to sign up for free books for your children through Dolly Parton’s Imagination Library?
(indicate yes or no)		  *
Do you rent or own at the service location?   *
Would you like to round your bill up to the nearest dollar each month?
The Member to Member Bill Round Up Program is the OTEC Member Foundation's very own voluntary donation program, with monetary donations collected used to support local emergency relief needs and programs within OTEC's four county service territory.		   *
Please select your preferred Billing Method:  
Please select your preferred Delinquent Method:  
 
The above named Applicant(s) hereby applies for membership with Oregon Trail Electric Cooperative (OTEC), and in consideration of the acceptance and approval of this Application by OTEC, agrees as follows. I (we) also agree to the Prepaid Metering Agreement, if applicable. I (we) also agree to receive text messages from OTEC.
I understand that checking this box and typing my name in the field provided below is my electronic signature. I (WE) AGREE TO THE TERMS AND CONDITIONS OF THIS APPLICATION.
  Applicant Name:     *