2. Yes! I wish to enroll in the Nights and Weekends Rate Plan.

4. Off peak hours are:

   • 8 p.m. to 8 a.m. Monday-Friday
   • Weekends - all day Saturday and Sunday
   • All day on New Year's Day, Memorial Day, Independence Day, Labor Day, Thanksgiving Day, Christmas Day

6. Applicant Information

8. First Name*
9. Last Name*
11. Utility Account Number (found on your statement)*
13. Service Address (Street)*
15. Address
17. City*
18. State*
19. Zip*
21. Primary Phone Number*
23. Email Address*

25. Participation in the Nights and Weekends Rate Plan is optional and does not involve any enrollment costs. You will be required to remain on the plan for one full year from the date of enrollment. 

27. Customer Signature*
29. Date*
    Date
Leave This Blank:


31. 1. Receive an email copy of this form.
32. Email address

    This field is not part of the form submission.

33. Submit

* indicates a required field