Guardian Credit Union, Montgomery, Alabama

PRIMARY MEMBER

First Name : MI : Last Name :

How do you qualify for membership?

If you are eligible for membership based upon a blood relative or "other" reason than above, please specify:

Date of Birth :	SSN :
Address :
City :
State :	Zip :
Home Phone :
Work Phone :
Drivers License :	State Issued: :
Employer :
Email :
Life Savings Insurance Beneficiary:

JOINT MEMBER

First Name : MI : Last Name :

Date of Birth :	SSN :
Address :
City :
State :	Zip :
Home Phone :
Work Phone :
Employer :
Drive License :	State Issued :
Email :
Life Savings Insurance Beneficiary:

You will receive a form by mail for your signature as well as additional information about your account, including your account number. This application is subject to approval by Guardian Credit Union. By submitting this application, you authorize Guardian Credit Union to verify credit and employment by any necessary means, including request for a credit report by a credit reporting agency.



*If you wish submit this request by mail, complete the application, print it, and sign on the signature line below. Mail the completed and signed application to: Guardian Credit Union, P.O. Box 3199 - Montgomery, AL 36109-0199 ___________________________________ Signature (only if submitting by regular mail)