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Apply Online For Membership

"Apply Online"

 

Online Membership Application

Please complete all your details in the form below, and click submit when you have finished.

Online Membership Application
* Required Fields

Surname:

*

Forename:

*

Title:

*

Gender:

*

Home Address:

*

Postcode:

*

Home Telephone:

*

Mobile Number:

Email Address:

Date Of Birth:

*

Home Status:

*

If you are a housing association tenant please state which one:

 
Household Income
* Required Fields

Annual Household Income:

*

Which council is your council tax paid to?:

 
Equal Opportunities Monitoring
* Required Fields

Hertsavers Credit Union Ltd aims to provide services to people of all ages and backgrounds. To ensure that we are providing an equitable service to all sectors of the community, and for that purpose only, we need to ask you some questions. The information you give us will be kept strictly confidential and will in no way affect the service that

Would you classify yourself as (Please select one classification):

*

Do You Regard Yourself As Disabled:

*

The Disability Discrimination Act 1995 states that the person has a disability for the purpose of this act if he/she has a physical or mental impairment which has substantial and long term adverse effect on his/her ability to carry out normal day to day activities

How Did You Hear About the Credit Union:

*
 
Employment Details
* Required Fields

If you are in employment please fill in the details below (Note - it is not necessary to be employed to join)

Are in employment:

*

Employer:

Employers Address:

Postcode:

National Insurance Number:

Work Telephone:

Are you in receipt of any state benefits?:

*
 
Account Details
* Required Fields

Bank Account Registration
(Please provide bank account details that allow us to make future transfers from the credit union direct to your account. Please note this is not compulsory)

Bank Name & Address:

Account Name:

Sort Code:

Account Number:

Account Password
(Setting an account password will allow us to take withdrawal requests over the phone, and adds extra security to your account. Please note this is not compulsory)

Password:

Password Hint:

We send out semi-annual statements to our members. How would you prefer to receive your statement?:

 
Declaration
* Required Fields

We are legally obliged to keep your details and identification on file in order to open your account and for this we need your consent. We undertake to keep your information secure and not to pass your details on to any third parties without your consent.

I hereby apply for membership and agree to abide by the rules of HertSavers Credit Union Ltd. I declare that the information given by me on this form is true and correct to the best of my knowledge and belief. I understand that a membership fee of £2 will be deducted from my first payment into HertSavers Credit Union Ltd. I agree that HertSavers Credit Union Ltd may use my information to contact me in the future with further information about the credit union.

Signature: *

Tick to Confirm

Date:

By clicking in the signature box above a tick will be inserted which will represent your electronic signature.

When you click on the ‘submit’ button, your application will be sent electronically to the credit union for processing. The credit union will conduct an online ID check to verify your identity and address. If this is successful, you will receive your Welcome Pack through the post within 14 days. If, for any reason, we are unable to verify your identity we will get in touch to arrange for you to provide us with your identity documents to complete the sign up process.



 
Updated: 29 August 2013