Membership application form
 
To be eligible to join the Credit Union, you need to be aged 18 or over.

Please note that this process is not a 'real time' transaction and that there will be a short delay between your submission and the application being processed within the credit union office.

  • ALL fields marked with an "*" are mandatory and you must enter/select the appropriate information.
PERSONAL details:
 
Title: *
Forename: *
Middle name(s):
Surname: *
 
Household status: *
Home address House number or:
  Flat number:
  Street *
  Town *
  District
  Postcode: *
Time at address:   years months
 
Sex: *
Date of birth: / / * (Age: )
National insurance number: *
Ethnicity: *
E-mail: *
Home telephone: *
Mobile telephone:
 
ID verification methods:
 
Please provide a mimimum of one of the following items in order to verify your identity.
 
Driving licence number
 
 
Passport number
 
 
Work details:
 
Employment status: *
 
Beneficiary details:
 
Beneficiary name:
Relationship to you:
Beneficiarys address: House/Flat No and street name:
Town:
District:
Postcode:
Beneficiarys contact number:
 
Banking details
 
Sort code:
Account number:
Building society roll number: (if applicable)
Name on account:
 
Additional information
 
I * wish to receive annual statements from the credit union via email. Statements not sent via email will be sent via post.
 
I * wish to receive promotional information from the credit union via email.
 

DATA PROTECTION STATEMENT

In accordance with the principles of the Data Protection Act 1998 we will use your personal details for the purposes of establishing your identity and managing your account with the Credit Union. Your personal details will be treated confidentially and will only be shared with other agencies for the purpose of credit referencing and debt recovery for which the credit union hold the appropriate Consumer Credit Licence.
 
DECLARATION
 

I * to abide by the rules of the Credit Union and declare that the information given by me on this form is true and correct to the best of my knowledge and belief.

By submitting this form, you are agreeing to an online ID check. This is not a credit check.
 
Human verification