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Membership Application Form

To apply for membership to Bethlehem 1st FCU, please print out, then bring, fax or mail this completed form to:
Bethlehem 1st Federal Credit Union
2317 Easton Ave.
Bethlehem, PA 18017
Voice: 610-691-0041 / Fax: 610-691-8624

 

IMPORTANT INFORMATION ABOUT PROCEDURES 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 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 may also ask to see your driver’s license or other identifying documents.
You may enter information on this form using your computer, but you cannot save it. You MUST print it out once you have completed it.
Name of Person Applying for Membership: Last: First: Middle Initial:
Social Security #:
Driver’s License #:
Date of Birth:
Mother’s Maiden Name:
Employer:
Membership Eligibility: I am affiliated with this Bethlehem 1st FCU member organization:

My relationship with this member organization: (choose one):
I am an Employee.
I am a member of the immediate family of an employee
I am a member of the immediate family of a current member.
I am a student at Bethlehem Catholic High School, Bethlehem Area Vo-Tech,
Freedom High School, Liberty High School, Moravian College, or LV Charter HS for the Arts.
Address:
Apt:

City:
State:
Zip:
Telephone
(include area code):		 Home: Work:
E-Mail Address:
Please check all Credit Union products you are requesting: Shares (savings)
Share Draft (checking)
Overdraft Protection
VISA Debit Card
Audio Response (Bank-By-Phone)
Vacation Club
Holiday Club
Share Certificates
Payroll Deduction

If this will be a joint membership, please also fill out the following section:

Name of Joint Applicant: Last: First: Middle Initial:
Social Security #:
Driver’s License #:
Date of Birth:
Mother’s Maiden Name:
Address:
Apt:

City:
State:
Zip:
Telephone:
(include area code)		 Home: Work:
E-Mail Address:

 Please note:

  1. To activate your membership, an account signature card must also be signed in person by you (and by the joint member, if there is one).
  2. If you bring this completed form to the Credit Union, you may sign the signature card immediately.
  3. If you fax or mail this form to us, we will contact you when the signature card is available to sign.
FOR OFFICE USE ONLY
Received By: _______________________ Date: _______________________
membershipapplication.html Rev 1/13/2016