Membership Application

Please be prepared to upload the following:

  • 2 forms of identification — Drivers License and a 2nd ID (the 2nd ID can be your SSN card, Work Photo ID, other government ID, passport, or current debit/credit card)

Account Type

All of the terms, conditions, form of account selection and other information indicated on this card apply to all of the account listed unless the Credit Union is notified in writing of a change.
Membership Eligibility *
  • - select a option -
  • Richmond Public Schools
  • Virginia Union University
  • Bon Secours Richmond Community Hospital
  • Metroplitan Business League and Association
  • City to City Auto Sales (MBL Partner)
  • Southside Community Development and Housing Corporation
  • Education Services Corporation n of Virginia
  • The Market @25th Street (MBL partner)
  • Live, work or worship in Blackwell, Manchester or Swansboro
  • Immediate family members of any current member
  • Urban League Young Professionals
  • Other
Select Account Type *
Please Specify
The account number for each of the account listed consists of the suffix added to the end of the member number listed in the "MEMBER APPLICATION AND OWNERSHIP INFORMATION" section. if this card applies to more than one account of the same type, more then one suffix will be listed for that account type.

Member application and ownership information

Member /Owner *
Cell Phone *
Date of Birth *
Street *
City *
Zipcode *
State *
Work Phone *
Home Phone *
Email *
Driver's Lic No. *
SSN/TIN *
Employer *

Account Services

Account Services

Payable On Death Designations (Optional)

Do you want to designate a Payable on Death (POD) representative on this account?
Payee
Street
City
State :
Zip

UTMA – Uniform Transfers to Minors Act account (Optional)

Do you want to open an UTMA account for a minor (age 1 year to 17 years old)
Custodian 1 (For Minor Optional)
Custodian 1 - Name
Custodian's Address
Phone
Date of Birth
SSN/TIN
Custodian 2 (For Minor Optional)
Custodian 2 - Name
Custodian's Address
Phone
Date of Birth
SSN/TIN
As Custodian(s) For Minor
As Custodian(s) for Minor Name
Phone
Minor's SSN/TIN
Minor's age under the Virginia Uniform Transfers to Minors Act

UTMA Designation of Successor Custodian (Optional)

Pursuant to the Virginia Uniform Transfers to Minors Act, I hereby designate succerror custodian(s) for all account listed in the "ACCOUNT TYPE" section. This designation shall take effect only upon my death, resignation, incapacity or removal
Successor name
Name of custodian
Signature of Custodian
Date
Name of Witness
Signature of Witness
Date

Designate ownership of the accounts and responsibility for the services requested

Designate ownership *
Joint Owner
Street
City/State/Zip
Home Phone
Work Phone
SSN/TIN
Driver's Lic No.
Date of Birth
Password
Email
By signing below, I/we agree to the terms and conditions of the Membership and Account Agreement, Truth-in-Savings Disclosure, Funds Availability Policy Disclosure, if applicable, and to any amendment the Credit Union makes from time to time which are incorporated herein. I/We acknowledge receipt of a copy of the agreements and disclosures applicable to the accounts and services requested herein. If an access card or EFT service is requested and provided, I/we agree to the terms of and acknowledge receipt of the Electronic Fund Transfers Agreement and Disclosure. The Internal Revenue Service does not require your COMM to any provision of this document other than the certifications required to avoid backup withholding.
Upload Signature *
Name *
Select Date
Two IDs Required
* Please make sure your ID information is clear and readable. If not, we cannot process your application.
Step 1: Upload Valid Driver's License *
Upload your documents... (Max File Size 10mb)
Step 2: Upload 2nd ID - SSN Card Work ID, Debit Card, Credit Card, Passport. Voter's Card, Other Governmant ID *
Upload your documents... (Max File Size 10mb)
* Please check all the details entered before submitting

* On your Phone, if the SUBMIT button does NOT upload:

  • Click the menu bar (top left)

  • Click Links

  • Scroll, click Single Membership Application

  • Click the navigation bar (bottom right)

  • Click Desktop Version

  • Enter name and email address to sign on