ELIGIBILITY

I'm eligible to join Allied Healthcare Federal Credit Union (AHFCU) because I'm: *

An Employee of __________________ :

A relative of AHFCU member :

An employee of *

Phone No. *

Ext.

Position *

Employment verification *

I understand proof of employment is required to qualify for membership.

A relative of AHFCU member, (Name of Member) *

Phone No. *

Relation *

Products You Might be Interested in (Select all that apply)

Shares *

Loans

PERSONAL INFORMATION

Account No. *

Name (Last, First, Middle) *

Driver's License *

Social Security No. *

Birthdate * +

Mother's Maiden Name *

Phone *

Physical Address (PO Box not allowed) *

0/40 characters

Physical Address Line 2 (PO Box not allowed)

0/40 characters

City *

0/20 characters

State *

Zipcode *

Alternative Mailing Address

Alternative Mailing Address Line 2

City

State

Zip Code

Email *

Confirm Email *

Would you like to add a Joint Owner? *

Yes

No

Joint Owner Name (If Applicable) *

Social Security No *

Birthdate * +

Driver's License *

Phone *

Address *

0/40 characters

City *

0/20 characters

State *

Zipcode *

IMPORTANT INFORMATION ABOUT PROCEDURE 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 me: When I open an account you will ask for my name, address, date of birth, and other information that will allow you to identify me. You may also ask to see my driver’s license or other identifying documents. All ID’s must have a picture.

AUTHORIZATION

AGREEMENT: In this Membership Invitation “I” and “My” mean each and every person who signs the attached Signature card. “You” and “Your” mean Allied Healthcare Federal Credit Union (AHFCU). If I am not currently a member, I hereby make application for membership in AHFCU. By signing the Signature Card I am requesting access to the Stat Line Audio Response system. By signing the Signature Card, I agree to conform to your by laws as well as all applicable terms and conditions set forth in the Account Agreement, Truth in Savings Disclosure, the Certificate Account Agreement and Disclosure, Electronic Services Disclosure and Agreement (receipt of all is acknowledged and incorporated by this reference). I understand and agree that this Membership Invitation shall govern the Primary Share Account, The Share Draft Account, MasterCard Debit Card, ATM Card and all other accounts designated above. I authorize you to open other accounts for me by telephone or in person. By signing the Signature Card below, I also authorize you to gather whatever credit, checking account and employment information you consider appropriate from time to time. I understand that this will assist, in determining my initial and ongoing eligibility for an account. I authorize you to give information concerning your experience with me to others. I understand and agree that you may retain this Membership Invitation and any other information you receive and I waive my right to confidentiality of my records to with the Department of Motor Vehicles (DMV) and authorize you to obtain such information from the DMV. I also understand my information will be verified through Chex Systems.

Authorization *

I have read, understand and agree to the terms for the authorization above.

Authorization *

Driver License *

Employment Verification