By completing and submitting this application, you are applying for service as a National Grid customer. As a customer of National Grid, you agree to accept financial responsibility at the applicable rate schedules, charges, and terms of your service classification, including service rendered to a third party at your request. Two forms of identification may be required with this application and one or both should include your date of birth and photo.

Additionally, National Grid may ask you for a copy of the lease or deed for the premise if one or more of the conditions below exist at the address you are requesting service:

History of theft of service/meter tampering
Consumption on an inactive meter
Valid disconnect notice
Cut out for non-payment

NEW ACCOUNT INFORMATION (All * fields are required)

ACCOUNT HOLDER INFORMATION:

Customer Name:

Cell Number:

Home Number:

Email Address:

Customer Number:

NOTE: Customer Number can be found in email.

Paperless Billing:

YesNo

Date of Birth:

ACCOUNT ADDRESS: Please enter the address where you want service.

Street Address:

City/State/Zip:

Bldg./Floor/Apartment Number:

Move In Date:

Service Type Requested:

Electric OnlyGas OnlyBoth Electric and Gas

MAILING ADDRESS (if different than above): Please enter the address you want your bills to be mailed.

Street Address:

City/State/Zip:

Bldg./Floor/Apartment Number:

ACCESS TO METERS: If you do not control access to the meter(s), enter the name and address of the person who can provide access.

Property Owner:

Phone Number:

Property Manager:

Phone Number:

In order to disconnect or final your National Grid service, you must call our Customer Service Contact Center at 1-800-642-4272 OR enter your request at our website www.nationalgridus.com. You will be responsible for all charges at this service address until a disconnect is requested by you and you provide access to the Meters for National Grid to stop your service.

Contact Information