Notice: A Customer Processing Charge of $28.00 will be added to your first billDate form filled out (mm/dd/yyyy)(Required) Month Day Year Have you ever had service with McMinnville Water & Light?(Required) Yes No Previous Address(Required) Street Address Address Line 2 City State AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code New Service Address(Required) Street Address Address Line 2 City State AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Valid Photo ID and Rental/Lease Agreement or Proof of Ownership required for all Service Connections The last 4 digits of the Social Security Number are provided voluntarily and are not required for service; Collection is made by authority of the MW&L Commission rules for customer service; The last 4 digits of the SSN will be used by MW&L for account security, to prevent identity theft, and for use in collection of delinquent payments. Further public disclosure is limited by law. See ORS 192.355(28).Mailing Address Check here if Mailing Address is Same as Service Address Your Mailing Address(Required) Street Address Address Line 2 City State AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Applicant Name(Required) First Middle Last Last 4 of Social Security Number:(Required)Date of Birth (mm/dd/yyyy)(Required) Month Day Year Driver's License or ID(Required) Employer(Required) Best Contact Number(Required)Secondary Phone Number(Required)Email Address(Required) Is there a Co-Applicant?(Required) Yes No Co-Applicant Name(Required) First Middle Last Last 4 of Co-Applicant Social Security Number:(Required)The last 4 digits of the Social Security Number are provided voluntarily and are not required for service; Collection is made by authority of the MW&L Commission rules for customer service; The last 4 digits of the SSN will be used by MW&L for account security, to prevent identity theft, and for use in collection of delinquent payments. Further public disclosure is limited by law. See ORS 192.355(28).Co-Applicant Date of Birth (mm/dd/yyyy)(Required) Month Day Year Co-Applicant Driver's License or ID(Required) Co-Applicant Employer(Required) Co-Applicant Best Contact Phone Number(Required)Co-Applicant Secondary Phone Number(Required)Co-Applicant Email Address(Required) Date to Start Service (mm/dd/yyyy)(Required)Business Days (Monday through Thursday) Month Day Year Would You Like to Sign up for Automatic Payments from Checking Account?A voided check is required. Yes No Sign up for Automatic Payments from Checking AccountType initials. A voided check is required. Processing Fee Acknowledgement(Required) I acknowledge a Customer Processing Charge of $28.00 will be added to my first billConsent I hereby verify the information to be true and complete, and I agree to the terms and conditions. Falsification of information can be used as justification for termination of service. I understand that by typing my full name and pressing the Submit button, this form submission will be stamped with today’s date and authorized by me as if I had signed my signature.Applicant Electronic Signature (Type Full Name)(Required) Co-Applicant Electronic Signature (Type Full Name)(Required) HiddenFile upload (OLD)Upload your documents.Max. file size: 200 MB.File uploadUpload your documents. Drop files here or Select files Max. file size: 200 MB. Contact Information E-Mail office@mc-power.com, Phone (503) 472-6158, PO Box 638, 855 NE Marsh Lane, McMinnville, OR 97128 CAPTCHACommentsThis field is for validation purposes and should be left unchanged.
