FacebookThis field is for validation purposes and should be left unchanged.Member Name(Required) First Last Member Address(Required) Street Address 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 Account Number(Required)Attached to and made a part of the Member's Electric Service Agreement.MidSouth Electric Co-op is offering Residential Members the opportunity to participate in its community solar program by subscribing to MidSouth Solar Energy and agreeing to purchase blocks of power equivalent to 100 kWh each (“Solar Block”) to be credited against the Member’s electric usage on each month’s bill (“Solar Block Credit”). Solar Block Credit(s) Terms & Conditions: Available to Standard Residential Billed Members only. Applied to 1 meter location assigned to 1 membership number. Non-transferable from 1 membership to another (Members may transfer Solar Block Credits from the Member’s residential meter location to another residential meter location belonging to the same Member within the MidSouth Service Territory). Not accumulative and must be applied each month or lost. Cannot exceed a Member’s actual electric usage in any 1 month. Subject to minimum and maximum allowed credits established by the MidSouth Electric. Price is guaranteed for a term of 60 months. Number of BlocksPrice per Solar BlockSolar Block Credit 1 Block (minimum)$11.50/month100 kWh 2 Blocks$23/month200 kWh 3 Blocks$34.50/month300 kWh 4 Blocks$46/month400 kWh 5 Blocks$57.50/month500 kWh Member subscribes to purchase and Midsouth Electric agrees to sell to Member _______ Solar Block Credit(s) as follows:(Required)Please enter a number from 1 to 5.1. Participation One-time Charge of $25(Required)(date paid)2. Total Solar Block Credits Purchased(Required)(same as above)3. Solar Block Credit Price (# of Blocks x $11.50)(Required)(due monthly)Term of Agreement Start Date (MM/DD/YYYY)(Required)(5 years = 60 months) Month Day Year Term of Agreement End Date (MM/DD/YYYY)(Required)(5 years = 60 months) Month Day Year For the Term of the Agreement, Member agrees to pay the Solar Block Credit Price as part of Member’s monthly bill and MidSouth Electric agrees to credit Member’s monthly bill with ______ kWh of power usage. Should Member terminate Membership, this Agreement will become null and void, Member releases any right to the subject Solar Block Credit(s), and MidSouth Electric may resell such released Solar Block Credit(s) without further notice. MidSouth Solar is powered in part by generation at MidSouth Electric's solar community solar project. MidSouth Electric reserves the right to meet and subsidize generation needs as necessary. Member acknowledges that MidSouth Electric Service is governed by the Member’s Electric Service Agreement, the Cooperative’s Tariff, its Bylaws, and the terms of this Solar Power Block Credit Agreement.For the Term of the Agreement, Member agrees to pay the Solar Block Credit Price as part of Member’s monthly bill and MidSouth Electric agrees to credit Member’s monthly bill with ______ kWh of power usage. Should Member terminate Membership, this Agreement will become null and void, Member releases any right to the subject Solar Block Credit(s), and MidSouth Electric may resell such released Solar Block Credit(s) without further notice. MidSouth Solar is powered in part by generation at MidSouth Electric's solar community solar project. MidSouth Electric reserves the right to meet and subsidize generation needs as necessary. Member acknowledges that MidSouth Electric Service is governed by the Member’s Electric Service Agreement, the Cooperative’s Tariff, its Bylaws, and the terms of this Solar Power Block Credit Agreement.(Required)Member Consent(Required) I hereby verify the information to be true and complete and agree to the terms and conditions. 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.Member Signature (Full Name)(Required)Co-Member Signature (Full Name)(if applicable)
