Membership Application

* Required Fields

Effective October 1, 2003

In accordance with section 326 of the USA Patriot Act, Financial Partners Federal Credit Union is required by Federal law to obtain, verify, and record information that identifies each person who opens an account or is being added as a signatory to a new or existing account. In some cases, identification will be requested for those banking with us prior to the effective date of the customer identification requirements because original documentation was not obtained with the opening of the accounts.

What this means for you:

When you open an account or are going to be added as a signatory to an account, we will ask for you 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.

General Information
Please provide all the requested information. When you have completed the form, press the Submit button to send your application. If necessary, we will contact you for additional information.

If you wish to apply for a loan as well, please note this in the Special Instructions/Comments field at the end of the application and the Credit Union will contact you. There is no need for you to fill out a seperate loan application as long as you include this information.

Will there be a co-applicant on this application?
Membership Eligibility:
Primary Applicant
Date of Birth:
 /   / 
Backup Withholding Tax:
Citizenship:
Home Address
Residence Type:
Mailing Address (if different)
Present Employer
Co-Applicant (if applicable)
Date of Birth:
 /   / 
Home Address
Residence Type:
Mailing Address (if different)
Present Employer
Co-Applicant 2 (if applicable)
Date of Birth:
 /   / 
Home Address
Residence Type:
Mailing Address (if different)
Present Employer
Nearest Relative Not Living With You
Additional Information
How would you like to be contacted?
The Internal Revenue Service does not require your consent to any provision of this contract other than the certifications required to avoid backup withholding.

If you wish to apply for a loan as well, please note this in the Special Instructions/Comments field and the Credit Union will contact you. There is no need for you to fill out a seperate loan application as long as you include this information.

Security Code:

Equal Housing Lender National Credit Union Administration
NCUA - Your savings federally insured to at least $250,000 and backed by the full faith and credit of the United States Government. National Credit Union Administration, a U.S. Government agency. Equal Housing Lender - We do business in accordance with the Fair Housing Law and Equal Opportunity Credit Act