Application for Average Billing Plan

Thank you for being a member of Coastal Electric. As a convenience to our members we offer average billing for qualifying member accounts. To apply for this service, please fill out and submit this form. If you have any questions, call us at (912) 884-3311 or email us at contact@coastalemc.com.

*Name on Account: Coastal Account: *Service Address: Apt/Unit/Lot: City: State: Zip: Home Phone Number: Work Phone Number: *E-Mail Address: What is your preferred method of contact if necessary? *Preferred contact method:  Postal Mail Telephone (Home) Telephone (Work) Email Please acknowledge the guidelines for joining this plan: I am aware my account must have a zero balance to qualify for this plan. I have been a Coastal Electric member for more than 12 months and have had no more than two late payments. To remain on the plan, I know I must pay the full billing amount each month by the due date. I know once I've been taken off the plan I must wait a year before applying to be in the plan again.

I understand that by submitting this form I am applying for my account to be placed on an average billing plan. Acceptance into the plan is based on meeting the criteria listed above.