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Type of Membership:
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USA PATRIOT ACT INFORMATION
To help the government fight the funding of terrorism and money laundering activities, Federal law requires all financial
institutions to obtain, verify, and record information that identifies each person who opens an account.
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First Name*:
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Middle Name/Initial:
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Last Name*:
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What this means for you: When you open an account, we will ask for your name, address, date of birth, and other
information that will allow us to identify you. We may also ask to see your driver’s license or other identifying documents.
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Mother's Maiden Name*:
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SSN/TIN*:
Not Yet Issued/No SSN Assigned
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Date of Birth (MM/DD/YYYY)*:
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ID Type:
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Driver's License Number*:
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Issuing State*:
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Passport Country:
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You may enter your State ID or Passport Number. If passport Number
Select Passport as Issuing State.
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ID Expiration Date (MM/DD/YYYY)*:
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Gender:
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Membership Affiliation*:
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Occupation*:
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Unisex Sweatshirt Size
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Please choose which Affiliation applies to your Membership.
*Sweatshirts will be mailed within 4-6 weeks of account opening and must be open and in good standing.
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Address Type:
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Address Line 1*:
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Address Line 2:
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No P.O. Boxes Please
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Zip Code*:
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City*:
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Country
State*:
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Mobile Phone Number:
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Home Phone Number:
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Home Phone or Mobile Phone must be given.
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E-mail Address*:
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Verify E-mail Address*:
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The email addresses entered do not match.
The email addresses entered match.
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If your mailing address is different please check here.
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Address Type:
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Address Line 1*:
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Address Line 2:
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Zip Code*:
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City*:
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Country
State*:
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First Name*:
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Middle Name/Initial:
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Last Name*:
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Mother's Maiden Name*:
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SSN/TIN*:
Not Yet Issued/No SSN Assigned
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Date of Birth (MM/DD/YYYY)*:
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ID Type:
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Driver's License Number*:
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Issuing State*:
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Passport Country:
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You may enter your State ID or Passport Number. If passport Number
Select Passport as Issuing State.
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ID Expiration Date (MM/DD/YYYY)*:
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Gender:
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I am a U.S. Person (including a U.S. Resident Alien)
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Occupation*:
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Address Same as Primary
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Address Type:
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Address Line 1*:
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Address Line 2:
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No P.O. Boxes Please
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Zip Code*:
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City*:
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Country
State*:
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Mobile Phone Number:
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Home Phone Number:
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Home Phone or Mobile Phone must be given.
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E-mail Address*:
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Verify E-mail Address*:
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The email addresses entered do not match.
The email addresses entered match.
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If your mailing address is different please check here.
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Address Type:
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Address Line 1*:
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Address Line 2:
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Zip Code*:
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City*:
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Country
State*:
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First Name*:
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Middle Name/Initial:
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Last Name*:
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Mother's Maiden Name*:
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SSN/TIN*:
Not Yet Issued/No SSN Assigned
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Date of Birth (MM/DD/YYYY)*:
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ID Type:
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Driver's License Number*:
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Issuing State*:
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Passport Country:
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You may enter your State ID or Passport Number. If passport Number
Select Passport as Issuing State.
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ID Expiration Date (MM/DD/YYYY)*:
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Gender:
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I am a U.S. Person (including a U.S. Resident Alien)
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Occupation*:
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Address Same as Primary
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Address Type:
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Address Line 1*:
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Address Line 2:
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No P.O. Boxes Please
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Zip Code*:
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City*:
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Country
State*:
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Mobile Phone Number:
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Home Phone Number:
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Home Phone or Mobile Phone must be given.
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E-mail Address*:
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Verify E-mail Address*:
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The email addresses entered do not match.
The email addresses entered match.
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If your mailing address is different please check here.
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Address Type:
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Address Line 1*:
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Address Line 2:
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Zip Code*:
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City*:
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Country
State*:
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Share Savings - Required for Membership
This basic Share is required with a minimum balance of $5.00
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Checking
Debit Card
Basic Checking is a simple checking account that's easy to maintain. There is no opening balance, no minimum balance requirement,
unlimited check writing privileges, and free access to our online Bill Pay.
There is no interest earned on Basic Checking.
Interest Checking guarantees you will make the most out of every dollar. You get unlimited check writing privileges
and free access to our online Bill Pay, while at the same time earning competitive interest rates that are calculated
daily and the interest will be credited into your account monthly and compounded monthly.
Requires a minimum balance of $500 to avoid $8 monthly maintenance fee.
Courtesy Pay covers life's unexpected emergencies and saves you from the merchant NSF fees, interruption of services
and the embarrassment and inconvenience associated with returned payments or declined transactions. You must check the box
below to have this service on your debit card.
Opt-in Notice and Disclosure
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Please add Courtesy Pay to my debit card.
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Debit Card Design:
*The Card design you receive may vary based on current availability
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Card(S) for:
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Deliver Card To:
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Visa Credit Card(requires additional information.)
Student Visa
Amazingly low interest rates as low as 8.99% Annual Percentage Rate (specific rate determined by credit worthiness).
So if you carry a balance or if you've been thinking about saving money by paying off those higher interest rate
credit cards, this is the card for you! Plus, we'll help you close out those higher interest rate credit cards so
you'll have one easy monthly payment.
Annual cash back bonus of 1.10% on purchases and an interest rate as low as 12.99% Annual Percentage Rate
(specific rate determined by credit worthiness). This card provides the flexibility and rewards that you've been
looking for!
No annual fees, fixed interest rate, at least 25 day grace
period, ATM access, overdraft option.
Click here
to review our Visa Platinum and Cash Rewards Application and Solicitation Disclosure
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Credit Card Design:
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Deliver Card To:
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Auto Loan(requires additional information.)
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Home Equity Loan(requires additional information.)
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Mortgage Loan(We will contact you to follow up with additional information)
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Other Loan(requires additional information.)
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Employment Status*:
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Start Date (MM/DD/YYYY)*:
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Employer*:
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Job Title*:
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Gross Monthly Income*: (12345.67)
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Work Address*:
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Work Phone*:
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Monthly Housing Cost*: (12345.67)
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Student Verification*:
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Student Income Source*:
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Student Monthly Income*: (12345.67)
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No Joint
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Employment Status*:
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Start Date (MM/DD/YYYY)*:
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The joint loan applicant will be the first joint membership applicant. |
Employer*:
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Job Title*:
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Gross Monthly Income*: (12345.67)
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Work Address*:
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Work Phone*:
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Monthly Housing Cost*: (12345.67)
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