Outdoor Lighting Form

When completing the form below, please be sure to select the correct service you are requesting. Click here for descriptions and prices of outdoor lights.

When completing the form below, please be sure to select the correct service you are requesting.

Name on Account*
Prefix First Middle Last Suffix
Account Number*
Last 4 Digits of SSN (For Verification)*
Address*
Street Address Address Line 2 City State ZIP Code
Daytime Phone*
Best Time to Call Monday - Friday*
Service Requested*
Location*
Please describe, as exactly as you can, the location of the outdoor light that needs repairing, or the exact place that you want to have the light installed.
Light Direction
If installing a new light, please tell us which direction you want the light to shine: north, south, east or west or towards the house, toward the barn, etc.
Size & Type of Light*
Please select the size and type of outdoor light you wish to have installed
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Baldwin EMC