New Service Form
Thank you for applying for service with M-Pulse Fiber. If you have any questions regarding new service, please feel free to contact customer service during normal business hours at (662) 256-2962 or send an email to onlinerequest@monroecountyelectric.com.

We will consider a submitted form as intent to start the installation process.

Today's Date:  
Date Service is Desired:  *  
Type of Request:   *
Services:      *
Applicant Information:
First Name:		   *
Last Name:   *
Middle Initial:  
Social Security Number:--  *

Mailing Address:
Street Address/P.O. Box:  *
City:  *
State:  *
Zip Code:   *

Service Address: (Physical 911 Address of Location)
Service Address:   *
Additional Comments:  
E-mail:  *
Confirm E-mail:  *
Home Phone:--   *
Cell Phone:--   *
Work Phone:--   

Portal Site Access:
We offer a portal for online bill payment and account management. If you would like access to your account online, please create a password by using a combination of letters and numbers and also create a password hint.

If you have an Electric account with us, please leave the infomation below blank and use your existing Electric Account login. Your Electric and Fiber accounts can be managed with the same Portal login.
Internet Password:  
Confirm Internet Password:  
Password Hint:

Existing or Previous Service:
Have you ever had service with Monroe County EPA or M-Pulse Fiber?
*enter only digits that precede the dash (exp. 12345-001 should be entered as "12345")

    
Account Number:


Phone Only: Keep existing Phone Number or Get New Number?
(Indicate one)		  
Bank Draft: I WANT TO SIGN UP FOR AUTOPAY USING BANK DRAFT. *EXISTING ELECTRIC CUSTOMERS AGREE TO USE THE SAME BANK ACCOUNT INFORMATION ALREADY BEING USED FOR MONROE COUNTY ELECTRIC POWER ASSOCIATION
(Indicate Yes or No)		  *
Current Electrical Service Entrance:
(Indicate Overhead, Underground or Unknown)		  *
Do you own or rent the service location?   *
Preferred Billing Method:
GO PAPERLESS, sign up for E Bill!		   *
 
By submitting this request, I have read and agree as follows:
  • I CONFIRM I AM THE OWNER OF THE PROPERTY WHERE SERVICE IS BEING REQUESTED OR HAVE THE PERMISSION FROM THE PROPERTY OWNER.
  • I HAVE RECEIVED A COPY AND AGREE TO THE SERVICE APPLICATION/AGREEMENT WITH GENERAL TERMS AND CONDITIONS.
I understand that checking this box and typing my name in the field provided below is my electronic signature.
  Applicant Name:     *