2020 Credit Union Membership Application
To apply for membership please complete all questions. Dues pay for membership through December 31, 2020.
Credit Union Name
*
Primary Billing Contact
*
First Name
Last Name
Primary Billing Contact Email
*
Primary Contact Phone Number
*
-
Area Code
Phone Number
Directory Information
Total CU assets
*
Number of members
*
Credit Union Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Credit Union Phone Number
*
-
Area Code
Phone Number
Website
*
Fax
Please list all staff members you wish to include in the directory. Please include Name, title, email, and contact phone number.
Please select your Credit Union membership tier based upon your CU's asset size.
*
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( X )
Tier 1 - Up to $50,000,000
Free
$
Free
Tier 2 - >$50,000,000 to $100,000,000
Free
$
Free
Tier 3 - >$100,000,000 to $200,000,000
$599.00
$
599.00
Tier 4 - >$200,000,000 to $500,000,000
$699.00
$
699.00
Tier 5 - >$500,000,000
$899.00
$
899.00
Credit Card (Please list the name that appears on the card.)
Submit application
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