Membership Application

Please check to see if your organization is already a member before applying. If you wish to apply for Distribution or Transmission Company Membership, please call (651) 289-9600 x112 or email us for more information.

An explanation of MEA membership categories can be found here.

Company Information

Company Name

Address 1

Address 2

City

State

Postal Code

Telephone

Fax

Company Website

Primary Contact

This is the senior liaison between MEA and the member company

First Name

Last Name

Title

Address 1

Address 2

City

State

Postal Code

Telephone

Fax

Email Address

Additional Contacts

Contact 1

First Name

Last Name

Address 1

Address 2

City

State

Zip

Contact 2

First Name

Last Name

Address 1

Address 2

City

State

Zip

Contact 3

First Name

Last Name

Address 1

Address 2

City

State

Zip

Contact 4

First Name

Last Name

Address 1

Address 2

City

State

Zip

Contact 5

First Name

Last Name

Address 1

Address 2

City

State

Zip

Contact 6

First Name

Last Name

Address 1

Address 2

City

State

Zip

Contact 7

Address 1

Address 2

City

State

Zip

Contact 8

Address 1

Address 2

City

State

Zip

Membership Investment

Associate Membership Type

Total

The contents of this box are for testing purposes. This box will be removed when the form goes live.

Full-Time Employees

Part-Time Employees

Hotel/Motel Rooms

Restaurant Seats

Additional Associates

Additional Associates Cost

Additional Locations

Additional Locations Cost

Assets

Assets Cost

Additional Categories

Number Of Additional Categories

Additional Categories Cost

Additional Item 1 Cost

Additional Item 2 Cost

Additional Item 3 Cost

Additional Item 4 Cost

Additional Item 5 Cost

Additional Item 6 Cost

Additional Item 7 Cost

Additional Item 8 Cost

Additional Item 9 Cost

Additional Item 10 Cost

Annual Dues (charged to card)

Revenue Item

Tax (charged to card)

Fee (charged to card)

Temp Value For DropDown 1

MembershipType

Additional Item 2

Additional Item 3

Additional Item 4

Additional Item 5

Additional Item 6

Additional Item 7

Additional Item 8

Additional Item 9

Additional Item 10

Primary Directory Category

Additional Directory Categories

Select additional directory categories below by holding the "CTRL" key
Secondary categories may be subject to additional fees

Number of Full Time Employees

Number of Part Time Employees

Number of Rooms

Number of Seats

Number of Associates

Number of Locations

Millions in Assets

Enhanced Membership ($50)

Annual Membership Investment

Additional Items

Additional Categories Cost

One-Time Application Fee

Tax

Payment Type

NOTE: If selecting to pay by Check, please do not fill out the Credit Card Information section at the bottom of the form. Thanks.

Additional Information

I would like to subscribe to EnergyU.

Member Directory Information
Please provide a brief company description (250 characters max including spaces)

We are now doing business with the following MEA members
It is not a requirement to be presently serving MEA members

Number of Customers Served

Residential

Commercial

Industrial

Percentage of Electric Customers

Percentage of Gas Customers

Population of Area Served

Average Annual Consumption (Kwh) per Residential Customer

Average Annual Consumption (Mcf) per Residential Customer

# of Square Miles in Service Area

# of Miles in Distribution Line

# of Miles in Distribution Main

Gross Annual Electric Revenue

Gross Annual Gas Revenue

Number of Electric Employees

Number of Gas Employees

Electricity Transported On

Pipeline Used to Transport Gas

Billing Contact

Name

Address 1

Address 2

City

State

Zip

Credit Card Information

Credit Card Type MastercardVisaDiscoverAmex

Credit Card Number

Name on Card
Security Code
Valid Through
Address
City
State
Zip
Phone
Credit Card Email Address

We hereby apply for "Associate Company" Membership in Midwest ENERGY Association, Inc. (MEA), as set forth in the Association's Bylaws, Article IV, Section 2c. We understand that we will be billed annually, and upon receipt by MEA of our application, payment, and approval by the Membership Chair, be accepted as Associate members with the appropriate membership privileges.

We hereby apply for "Electric Level II" Membership in Midwest ENERGY Association, Inc. (MEA), as set forth in the Association's Bylaws, Article IV, Section 2c. We understand that we will be billed annually, and that we will then, upon receipt by MEA of our application, payment, and approval by the Membership Chair, be accepted as members with full membership privileges.

We hereby apply for "Energy Transmission Company" Membership in Midwest ENERGY Association, Inc. (MEA), as set forth in the Association's Bylaws, Article IV, Section 2c. We understand that we will be billed annually, and that we will then, upon receipt by MEA of our application, payment, and approval by the Membership Chair, be accepted as members with full membership privileges.

We hereby apply for "Energy Producer" Membership in Midwest ENERGY Association, Inc. (MEA), as set forth in the Association's Bylaws, Article IV, Section 2c. We understand that we will be billed annually, and that we will then, upon receipt by MEA of our application, payment, and approval by the Membership Chair, be accepted as members with full membership privileges.

We hereby apply for "Partners in Education" Membership in Midwest ENERGY Association, Inc. (MEA), as set forth in the Association's Bylaws, Article IV, Section 2c. We understand that we will be billed annually, and that we will then, upon receipt by MEA of our application, payment, and approval bye the Membership Chair, be accepted as Partners in Education members with the appropriate membership privileges.

We hereby apply for "Energy Marketer" Membership in Midwest ENERGY Association, Inc. (MEA), as set forth in the Association's Bylaws, Article IV, Section 2c. We understand that we will be billed annually, and that we will then, upon receipt by MEA of our application, payment, and approval by the Membership Chair, be accepted as members with full membership privileges.

We hereby apply for "Gas Level II" Membership in Midwest ENERGY Association, Inc. (MEA), as set forth in the Association's Bylaws, Article IV, Section 2c. We understand that we will be billed annually, and that we will then, upon receipt by MEA of our application, payment, and approval bye the Membership Chair, be accepted as members with full membership privileges.

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Associate/Contractor membership dues payment cancellation notifications received in writing less than 7 days after submission of the member application will result in a refund. No refunds will be issued after the 7th day.