Application for Service

Once the application, permit, and fee process has been completed, the connection of service can take up to 2 business days from desired date.  For security purposes, all social security numbers have been masked in the BECi System.

Note: All fields with the asterisk (*) are required.


Today's Date:  
Type of Request:  *
Applicant First Name:   *
Applicant Last Name:   *
Applicant Middle Initial:  
Social Security Number:-  -   *
Driver's License #:  *
State:  *
DOB (mm/dd/yy):  *
Maiden name/Former last name:  
Employer:  

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

Service Address:
Please enter the street address where service is required:
Service Address:   *
Service Type (Construction Required or Existing Service):  *
Parish of Service Address and Directions to Service Address:  
E-mail:  *
Confirm E-mail:  *
Primary Phone:-  -    *
Cell Phone:-  -   
Work Phone:-  -     
Spouse/Cohabitant:
(If you do not have a spouse please enter N/A)
  *
Social Security Number:-  -   
State:  
DOB (mm/dd/yy):  
Employer:  
Employer Phone Number:  

As one of our services, we provide an online application for viewing and paying bills. If you'd like to use this service, you can specify an Internet Password and Password Hint at this time. Please note that the Internet Password must be at least 4 characters in length and is case sensitive.

Internet Password:  
Confirm Internet Password:  
Password Hint:

A Membership Fee is chargeable only on the first service in a member’s name; additional services in the same name do not require membership fee. A security deposit will be required on all accounts and may be up to 2 ½ times the average monthly bill based on credit worthiness. Other fees may be assessed based on individual needs.

Membership Fee:  
Connection Service Charge:  

List person(s) authorized to access account(s):  
Service For (indicate Home, Mobile Home, APT, Farm/Barn/Shop, Camp or Church):  
Would you like to Connect a Yard Light at this location? (indicate yes or no)  
If yes, on existing pole or new BECi pole? (additional pole requires a $350.00 fee)  
Owner's Name:  *
Owner's Phone Number:  
Do you Own or Rent?  *
Please select your preferred billing method?  *
 
I have read and agree to the Terms of Service. By submitting this application request, I also agree that a credit check will be submitted to determine if a security deposit is required. A one time $5.00 membership fee applies.  I have read and understand the Permit Requirements.