Membership Application
 

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 for your name, address, date of birth, and other information that will allow us to identify you. We will also ask to see your driver's license and other identifying documents.

IMPORTANT INFORMATION ABOUT PROCEDURES FOR OPENING A NEW ACCOUNT

This form will not be transmitted by any electronic means and remains secure on our server. No information submitted herein is accessible to anyone outside of High Peaks Federal Credit Union. Our secure methods maintain absolute safety and confidentiality of your personal information.

 
* Indicates Required Fields
Are you eligible for membership in this Credit Union:
 Yes No * please read Eligibility Requirements before applying
* If so, how:
 
* First Name:
Middle Initial:
* Last Name:
Social Security Number:
* Date of Birth:
* Address:
* City:
* State:
* Zip Code:
* Telephone Phone:
* E-Mail Address:
Employer:
Employer's Address:
Employer's City:
Employer's State:
Employer's Zip Code:
Self-Employed:
 Yes No
Previous Address (if less than 2 years at current one):
Address:
City:
State:
Zip:
For secirty please check the box:
   
 
   
 
 
     
       
   
High Peaks Federal Credit Union
Dillon, Montana 59725-0029
Copyright © 2017 All Rightes Reserved