Membership Form

Are you eligible to join Campus Federal Credit Union?

If so, we can accept your membership application today! Becoming a member requires a minimum investment of one Credit Union share-$5-in a deposit account, plus a $5 one-time membership fee.

Please complete all requested fields on the following form. Each application will be checked for membership qualifications and verified through Chexsystems. When you have completed the form, press the SUBMIT button to send your application to Campus Federal. We will contact you within two business days regarding your membership and to provide instructions on how to complete your membership request.

Membership Qualification (See who is eligible to join):

I am a Family Member of:

or Employee of:

Account Desired:	Checking Savings and Checking Savings only Other

Additional Services Desired:		FAC (Financial Action Center) 24 hour telephone access to your accounts. FAC enrollment is required for initial access to Campus Federal's Online Banking.

Choose your four digital access code:

For Checking Accounts Only:	Check Card - Primary Owner Check Card - Joint Owner or ATM Card - Primary Owner ATM Card - Joint Owner

Overdraft Protection:	Yes No

From:	Savings Applied for Visa

Primary Owner of Account:

Last Name:

First Name:

Middle Initial:

Residence Address
(not PO Box):

City:

State

Zip

Mailing Address
(if different):

City:

State

Zip

E-mail Address:

Social Security
Number:

Driver's License
No.:

State Exp. Date

Home Phone:

Work Phone:

Date of Birth:

I am

am not subject to back-up withholding.

Mother's Maiden
Name:

Middle Initial

Joint Member Information

Joint Owner of Account:

Last Name:

First Name:		Middle Initial:

Residence Address (not PO Box):

City:

State		Zip

Mailing Address (if different):

City:

State		Zip

E-mail Address:

Social Security Number:

Driver's License No.:		State Exp. Date

Home Phone:

Work Phone:

Date of Birth:

I am		am not subject to back-up withholding.

Mother's Maiden Name:		Middle Initial

Relationship to Primary Owner:


To help the government fight the funding of terrorism and money laundering activities, Federal law requires all financial institutions to obtain, verify, and record all information that identifies each person who opens an account. 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 that you provide a copy of your driver's license or other identifying documents.

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Your savings federally insured to at least $100,000 and backed by the full faith and credit of the United States Government. This credit union is federally insured by National Credit Union Administration.