Request for Membership Change

Please complete the webform below OR the PDF here.

The undersigned does hereby release and surrender to Clark Energy Cooperative, Inc. all rights to Membership Certificate shown as:

Existing Membership Certificate

The undersigned does hereby apply for membership as follows:

Requested Membership Certificate

The undersigned also requests any capital credits and records associated with capital credits on the released certificate be assigned, transferred, and kept with the newly requested member certificate.

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