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Services
Locations
About
Resources
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- News
- Media
Careers
- Current Openings
- Apply Now
Contact
- Directory
- FAQ

Personal Credit Application

Resources

Personal Credit Application & Agreement

Your Social Security number will be required to set up a new account. Please contact Cooperative Energy Company after submitting this application to provide this information.

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Download a Printable
Credit Application

Download

"*" indicates required fields

Application For*

Fuel Cards

Propane

Fuel/Gasoline

Other

Is This A Joint Application?*

Yes

No

Number of Cards Requested*

Credit Limit*

Amount of Desired Monthly Credit ($)

Applicant Information

Applicant Name*

First Name Middle Initial Last Name

Date of Birth*

Month

Day

Year

Joint Applicant Name*

First Name Middle Initial Last Name

Joint Applicant Date of Birth*

Month

Day

Year

Address*

Street Address City State ZIP Code

Mailing Address*

Street Address City State ZIP Code

Home Phone

Cell Phone*

Email*

Do You Own Or Rent Your Home?*

Rent

Own

How Long Have You Lived At This Address?*

How Did You Find Out About Cooperative Energy?*

Friend/Neighbor/Business Associate

TV Advertisement

Radio Advertisement

Newspaper Advertisement

CEC Energy Specialist Team

CEC Employee

Social Media

Other

Employment

Applicant's Current Employer*

Position / Job Title*

Length of Employment*

Employer Address*

Street Address City State ZIP Code

Applicant's Monthly Income

Joint Applicant's Applicant's Current Employer*

Joint Applicant's Position / Job Title*

Joint Applicant's Length of Employment*

Joint Applicant's Employer Address*

Street Address City State ZIP Code

Joint Applicant's Monthly Income

Bank or Financial Institution

Bank Name*

Bank Branch*

Bank Officer*

Bank Address*

Street Address City State ZIP Code

Bank Phone

Account Type

Checking

Savings

Authorization*

I hereby authorize bank named above to release information requested for the purpose of obtaining and / or reviewing credit

Credit References

List three business references where credit has been extended. NOT CREDIT CARD COMPANY OR VERIZON/AT&T!

Reference #1

Phone*

Complete Address*

Street Address City State ZIP Code

Reference #2

Phone*

Complete Address*

Street Address City State ZIP Code

Reference #3

Phone*

Complete Address*

Street Address City State ZIP Code

Has applicant filed bankruptcy within the past seven years?*

Yes

No

If yes, please explain

Signature

Applicant Signature*

Joint Applicant Signature*

Something was wrong with the steering on my truck. I walked into the Sibley location and was pleasantly greeted by Mike Appeldorn. He patiently listened as I explained my issue. With no hesitation, he suggested we go have a look at it. In just a few moments he easily spotted the problem, a potentially dangerous one, caused by negligence on the part of an incompetent alignment company (Not in this area). Mike did not waist any time taking care of me and I was back on the road in no time at all. Thanks Mike and Cooperative Energy for potentially saving my family from harm.

Andy C.

Customer

I limped in after running over something that caused an oil leak. Being from Louisiana, I was fearing the worst on a Friday afternoon. Mike, the manager, told me the mechanic was leaving for lunch but he would put my car on the rack himself and take a look. I went next door for a sandwich and when I returned Mike had repaired the damage and I was back on the road. I would have gladly paid many times the small charge, but this man and this company were totally fair and honest.

Jim C.

Customer

Always ready to provide service when you need it. Great customer service!

Diamond Concrete & Construction

Customer

Always very helpful and friendly. Appreciate the great service!

Dean C.

Customer

Friendly, personalized service. Grateful to have them in town!

Debra

Customer

Very friendly and helpful. Check them out for tires, fuel, propane. The connivence store is really clean with courteous staff.