Sacred Heart Hospital Employees Credit Union

Individual Member Application Form

Please type information, print & forward to the Credit Union

IMPORTANT INFORMATION ABOUT PROCEDURES FOR OPENING A NEW ACCOUNT

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.  What this means for you: When you open an account, we will ask you 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.

 

Date    mm/dd/yy
First Name  
 Middle Name
Last Name   
Street Address
Address (cont)
City
State
Zip Code
Home Phone
Date of Birth mm/dd/yy
Birth City & State
Social Security Number use hyphens
Drivers License Number
Employer
E-Mail Address

Please print & forward to the Credit Union