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Outage Reporting: (816) 565-4942, (800) 491-3803, Pay-by-phone (855) 874-5349

Membership Application

Required fields are marked in Red, please complete form and submit to get Confirmation page.

After getting the confirmation page expect to be contacted within 1 business day.  Please contact the office if you do not get a phone call.


PO Box 452
Higginsville, MO 64037-0452

Membership Application

Spouse or other adult living in the household:

Mailing Address

Physical Address

Service Information

We will attempt to make connects on the following business day from the date.

Roundup Foundation Policy and Guidelines

** Type your name as you would sign it. If application is made for joint membership, both applicants must sign. Member will be called using one of the provided numbers prior to hookup. Connects are only performed during business hours 8:00-4:30 M-F.

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