Become A Board Member Application

Name

OK Name is required

Birth Date

OK Birth Date is required

Address

OK Address is required

Home/Cell

Optional OK Home/Cell is required

Business Phone Number

OK Business Phone Number is required

Employer

OK Employer is required

Position

OK Position is required

E-mail

OK E-mail is required

Credit Union Account Number

OK Credit Union Account Number is required

Member Since

OK Member Since is required

Please state why you wish to serve as a Board Member and what you feel you have to offer the Credit Union.

OK Please state why you wish to serve as a Board Member and what you feel you have to offer the Credit Union. is required

Please list any educational or practical experience you feel may benefit the Credit Union.

OK Please list any educational or practical experience you feel may benefit the Credit Union. is required

Please list all civic and group activities you are currently active in.

OK Please list all civic and group activities you are currently active in. is required

I certify that all of the information I have submitted is correct to the best of my knowledge, and that I have read and understand the list of Qualifications for Board Members, the Credit Union's Mission Statement, and the Credit Union's Code of Ethics.

OK I certify that all of the information I have submitted is correct to the best of my knowledge, and that I have read and understand the list of Qualifications for Board Members, the Credit Union's Mission Statement, and the Credit Union's Code of Ethics. is required

OK is required

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