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New Member Information

Please fill out this form completely and submit to Sawnee EMC.  Failure to provide this information could result in a delay in processing of application.

Member
Joint Member (if applicable)
Billing Address
Service Location
Previous Address
Employment
Contact Information

Demographic Information

Residential members only

As a participant in a Federal utilities financing program, the Sawnee Electric Membership Corporation is required to identify and document as accurately as possible the racial/ethnic data on the eligible population in our service area. We would appreciate your checking the appropriate group listed below and returning this form to us within 2 weeks.

Please note, your response is optional. The information you provide will be used only for FEDERAL GOVERNMENT REPORTING PURPOSES.

Should you have any questions, you may contact Ryan Satterfield at 770-887-2363 ext. 7583.


Thank you for your cooperation in this matter. 

Ethnicity

STATEMENT OF NONDISCRIMINATION 
UNITED STATES DEPARTMENT OF AGRICULTURE
Rural Electrification Administration
Appendix A
Statement of Nondiscrimination

Sawnee Electric Membership Corporation is the recipient of Federal financial assistance from the Rural Utilities Service, an agency of the U.S. Department of Agriculture, and is subject to the provisions of Title VI of the Civil Rights Act of 1964, as amended, Section 504 of the Rehabilitation Act of 1973, as amended,  the Age Discrimination Act of 1975, as amended,  and the rules and regulations of the U.S. Department of Agriculture which provide that no person in the United States on the basis of race, color, religion, national origin, sex, age, disability, citizenship or veteran status shall be excluded from participation in, admission or access to, denied the benefits of or otherwise be subjected to discrimination under and of this organization’s programs or activities.
The person responsible for coordinating this organization’s nondiscrimination compliance efforts is Michael A. Goodroe, President/CEO. Any individual, or specific class of individuals, who feels that this organization has subjected them to discrimination may obtain further information about the statutes and regulations listed above from and/or file a written complaint with this organization; or the Secretary, U.S. Department of Agriculture, Washington, D.C. 20250; or the Administrator, Rural Utilities Service, Washington, D.C. 20250. Complaints must be filed within 180 days from the alleged discrimination. Confidentiality will be maintained to the extent possible.