Coweta-Fayette EMC, Inc.

Please Read the Following Statements: (scroll down for the next button)

I hereby request that my gas marketer be changed to Coweta-Fayette EMC Natural Gas and I designate Coweta-Fayette EMC Natural Gas to act as my agent solely for the purpose of making this change of gas marketer. I understand that if this is more than a single switch in a 12-month period I will be subject to a $7.50 charge by AGLC for switching and that there may be a charge if I elect after this switch to switch back to my current marketer.

Notice: You may be assessed a security deposit based on information Coweta-Fayette EMC Natural Gas obtains from credit reporting agencies or other sources.Submission of this enrollment form authorizes Coweta-Fayette EMC Natural Gas to obtain your credit information, provided you have provided your Social Security # on the application form.

Notice: We will need your social security number in order to obtain a credit report and complete you application for service. If you do not wish to provide this information over the internet, please contact one of our customer service representatives at 770-502-0226 option 2 or toll free at 1-877-746-4362.

I have read and agree to Coweta-Fayette EMC Natural Gas's Terms of Service.

I have read and agree to Coweta-Fayette EMC Natural Gas's Disclosure Statement.

I certify that I am over 18 years of age and that I am authorized to request service for this address.

For customers who are moving into a new home, the charge for having residential gas service established is as follows:

$50.00 for New Gas Meter (to set and turn on new meter), this charge is passed through by AGLC

Requests made after 5 PM will be reviewed the following business day.

By Clicking Next Below You Agree To The Above Statements.

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