2020 Credit Union Membership Form

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. *

Tier 1 - Up to $50,000,000 Free

Tier 2 - >$50,000,000 to $100,000,000 Free

Tier 3 - >$100,000,000 to $200,000,000 $ 599.00

Tier 4 - >$200,000,000 to $500,000,000 $ 699.00

Tier 5 - >$500,000,000 $ 899.00

Directory Information