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To apply for membership with SPC Credit Union or to add additional services, complete the preliminary membership application below. If you are applying for a loan you will also need to complete the Loanliner application. Please provide all the requested information. When you have completed this form, press the Submit button to send your application to SPC for processing. Each application is subject to approval and will be checked for membership qualification. You will hear from us in two business days.

Fields noted with * and Bold are required to submit this application.

New Member (Please check the accounts you are applying for) Share Savings Account Share Savings and Share Draft Checking Account Share Savings and Other Account

Membership Eligibility: I am eligible for membership at SPC Credit Union through my: Employer Employer's Name Family Member Family Member's Name

Existing Members: Member Number: Add a Share Draft Checking Account Add Other Account

Select Account Type: Type of Share Draft Checking Select Basic Anytime Checking Prime Time Checking Student Checking Type of Other Account Select Christmas Club Share Certificate IRA IRA Share Certificate

Additional Services Desired: SPC NetBranch™ SPC ANYTIME Telephone Response SPC ANYTIME Visa Check Card ATM Card Direct Deposit

For Checking Accounts Only: Overdraft Protection Yes No Please select one of the following options for Overdraft Protection: Transfer funds first from line of credit; secondly, transfer from shares (savings). Transfer funds from share (savings) if available. Transfer funds first from shares (savings); secondly, transfer funds from line of credit. If you select option #1 or #3, you will also need to complete a loan application. Go to the Loan Application screen. Please provide all the requested information. When you have completed the form, click on the Submit button to send your application. Processing will take approximately two to four working days.

Primary Member of Account Last Name * First Name * Middle Initial Residential Address * City* State* Zip* Select Alabama Arkansas Arizona California Colorado Connecticut Delaware Florida Georgia Hawaii Iowa Idaho Illinois Indiana Kansas Kentucky Louisiana Massachusetts Maryland Maine Michigan Minnesota Missouri Mississippi Montana Nebraska New Hampshire New Jersey New Mexico Nevada North Carolina North Dakota New York Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington Wisconsin West Virginia Wyoming Mailing Address (if different) City State Zip Select Alabama Arkansas Arizona California Colorado Connecticut Delaware Florida Georgia Hawaii Iowa Idaho Illinois Indiana Kansas Kentucky Louisiana Massachusetts Maryland Maine Michigan Minnesota Missouri Mississippi Montana Nebraska New Hampshire New Jersey New Mexico Nevada North Carolina North Dakota New York Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington Wisconsin West Virginia Wyoming Social Security No. * Driver's License No. State of Driver's License Select Alaska Alabama Arkansas Arizona California Colorado Connecticut Delaware Florida Georgia Hawaii Iowa Idaho Illinois Indiana Kansas Kentucky Louisiana Massachusetts Maryland Maine Michigan Minnesota Missouri Mississippi Montana Nebraska New Hampshire New Jersey New Mexico Nevada North Carolina North Dakota New York Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington Wisconsin West Virginia Wyoming Home Phone Work Phone Email Address Date of Birth* Mother's Maiden Name*     Will there be a joint Member on this account? Choose One Yes No Joint Member Account Last Name First Name Middle Initial Residential Address City State Zip Select Alaska Alabama Arkansas Arizona California Colorado Connecticut Delaware Florida Georgia Hawaii Iowa Idaho Illinois Indiana Kansas Kentucky Louisiana Massachusetts Maryland Maine Michigan Minnesota Missouri Mississippi Montana Nebraska New Hampshire New Jersey New Mexico Nevada North Carolina North Dakota New York Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington Wisconsin West Virginia Wyoming Mailing Address (if different) City State Zip Select Alaska Alabama Arkansas Arizona California Colorado Connecticut Delaware Florida Georgia Hawaii Iowa Idaho Illinois Indiana Kansas Kentucky Louisiana Massachusetts Maryland Maine Michigan Minnesota Missouri Mississippi Montana Nebraska New Hampshire New Jersey New Mexico Nevada North Carolina North Dakota New York Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington Wisconsin West Virginia Wyoming Social Security No. Driver's License No. State of Driver's License Select Alaska Alabama Arkansas Arizona California Colorado Connecticut Delaware Florida Georgia Hawaii Iowa Idaho Illinois Indiana Kansas Kentucky Louisiana Massachusetts Maryland Maine Michigan Minnesota Missouri Mississippi Montana Nebraska New Hampshire New Jersey New Mexico Nevada North Carolina North Dakota New York Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington Wisconsin West Virginia Wyoming Home Phone Work Phone Email Address Date of Birth Mother's Maiden Name Relationship to Primary Memeber Second Joint Member Account Last Name First Name Middle Initial Residential Address City State Zip Select Alaska Alabama Arkansas Arizona California Colorado Connecticut Delaware Florida Georgia Hawaii Iowa Idaho Illinois Indiana Kansas Kentucky Louisiana Massachusetts Maryland Maine Michigan Minnesota Missouri Mississippi Montana Nebraska New Hampshire New Jersey New Mexico Nevada North Carolina North Dakota New York Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington Wisconsin West Virginia Wyoming Mailing Address (if different) City State Zip Select Alaska Alabama Arkansas Arizona California Colorado Connecticut Delaware Florida Georgia Hawaii Iowa Idaho Illinois Indiana Kansas Kentucky Louisiana Massachusetts Maryland Maine Michigan Minnesota Missouri Mississippi Montana Nebraska New Hampshire New Jersey New Mexico Nevada North Carolina North Dakota New York Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington Wisconsin West Virginia Wyoming Social Security No. Driver's License No. State of Driver's License Select Alaska Alabama Arkansas Arizona California Colorado Connecticut Delaware Florida Georgia Hawaii Iowa Idaho Illinois Indiana Kansas Kentucky Louisiana Massachusetts Maryland Maine Michigan Minnesota Missouri Mississippi Montana Nebraska New Hampshire New Jersey New Mexico Nevada North Carolina North Dakota New York Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington Wisconsin West Virginia Wyoming Home Phone Work Phone Email Address Date of Birth Mother's Maiden Name Relationship to Primary Memeber

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