Online Membership Application

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Apply for Membership
  1. Membership Eligibility and Disclosures

  2. Membership Eligibility(*)






    You must select one
  3. Please explain your eligibility:
  4. Explain Eligibility(*)
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  5. If I am eligible because of family member, please provide:
  6. Family Member's Name:(*)
    Please enter a valid name
  7. Family Member's Account Number
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  8. Required(*)
    You must agree to the disclosures to proceed!
  9.  
  1. Type of Ownership

  2. Type of Ownership(*)


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  3.  
  1. Primary Applicant Information

  2. First Name(*)
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  3. Last Name(*)
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  4. Residential Address(*)
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  5. City(*)
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  6. State(*)
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  7. Zip/Postal Code(*)
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  8. Daytime Phone(*)
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  9. Cell Phone(*)
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  10. Social Security Number(*)
    Please enter a valid social security number
  11. Type of Identification(*)
    Please select a valid option
  12. Identification Number
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  13. State of Issue
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  14. ID Expiration
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  15. Email(*)
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  16. Date of Birth(*)
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  17. Occupation(*)
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  18. Employer
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  19. Employer Phone No.
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  20. Work Address
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  21. City
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  22. State
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  23. Zip/Postal Code
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  24. Mother's Maiden Name(*)
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  25.  
  1. Joint Applicant Information

  2. First Name
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  3. Last Name
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  4. Residential Address
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  5. City
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  6. State
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  7. Zip/Postal Code
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  8. Daytime Phone
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  9. Cell Phone
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  10. Social Security Number
    Please enter a valid social security number
  11. Type of Identification
    Please select a valid option
  12. Identification Number
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  13. State of Issue
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  14. ID Expiration
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  15. Email
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  16. Date of Birth
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  17. Occupation
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  18. Employer
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  19. Employer Phone No.
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  20. Work Address
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  21. City
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  22. State
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  23. Zip/Postal Code
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  24. Mother's Maiden Name(*)
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  25.  
  1. Beneficiary Information

  2. The following beneficiaries are to receive the proceeds of my accounts at my death. If this is a joint account, the beneficiaries are to receive the proceeds only upon the death of both/all joint owners.
  3. Name
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  4. Relationship to Member
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  5. Date of Birth
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  6. Social Security Number
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  7. Address
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  8. City
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  9. State
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  10. Zip/Postal Code
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  11. Percent
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  12. If you have beneficiaries, you must enter a percentage. For one beneficiary, enter 100. For multiple beneficiaries, please ensure their combined percentages equal 100 percent.
  13. Do you have additional beneficiaries?
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  14. Name
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  15. Relationship to Member
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  16. Date of Birth
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  17. Social Security Number
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  18. Address
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  19. City
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  20. State
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  21. Zip/Postal Code
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  22. Percent
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  23. Do you have additional beneficiaries?
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  24. Name
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  25. Relationship to Member
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  26. Date of Birth
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  27. Social Security Number
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  28. Address
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  29. City
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  30. State
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  31. Zip/Postal Code
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  32. Percent
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  33.  
  1. Finalize Application

  2. I apply for membership in United Health Credit Union; I understand that I must pay a $1 lifetime membership fee and open a regular savings account, and that I must maintain a $25 minimum balance in that account in order to be eligible for other Credit Union services.
  3. Accounts to be Opened(*)


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  4. Would you like to upload your ID now?


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  5. Don't worry, you can always bring your identification with you when you complete your application!
  6. Please upload a current and valid government issued primary I.D. with photo (i.e., driver’s license, state issued I.D., passport, military I.D., alien registration card). If you do not have your identification handy or if you prefer to present it later, please stop by a branch to complete the application. Please limit your upload to 2MB per image.
  7. Upload Primary ID #1
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  8. Upload Joint ID #1
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  9. Enter Security Code(*)
    Enter Security Code   RefreshInvalid Input
  10. Please make sure your information is correct
      

Items marked with (*) are required.