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Tel: 01604 250016 Email:

19 August 2017
Online Membership Form

Prior to completing this form, please open and review the attached PDF concerning the protection of your deposits through the Financial Services Compensation Scheme (FSCS).

Click to DownloadDownload FSCS Information Sheet (126.5kb)

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

Online Membership Application
* Required Fields
Section One – Personal Information
Title : *
First Name(s): *
Surname: *
National Insurance Number: *
Home Telephone:
Mobile Telephone:
E-Mail Address:
Date of Birth: *
Have you ever previously been a member of Northamptonshire Credit Union in this or any other name? *
Previous Number (if known):
Surname used (if different):
Section Two – Address Details
* Required Fields
Address Line 1: *
Address Line 2:
Address Line 3:
Address Line 4:
Town: *
Postcode : *
Length of time at address (In years and months): *
If you have resided at your current address for less than three years, please provide your previous address
Address Line 1:
Address Line 2:
Address Line 3:
Address Line 4:
Length of time at address (In years and months):
Section Three – Employers Details
* Required Fields
N.B. It is not necessary to be employed to join Northamptonshire Credit Union.
Current Employer:
Address Line 1:
Address Line 2:
Address Line 3:
Address Line 4:
Section Four – Data Protection
* Required Fields
Northamptonshire Credit Union is registered to hold and process personal information (Registration No: Z8547560). All information you give us will be held in accordance with the Data Protection Act 1998 and will only be used to administer your account. It will not be shared with any other person or organisation without your written consent.
From time to time we may wish to send you information about us and our services. In which ways are you happy to receive this information?E-Mail
We will contact you to give you information of our Annual General Meeting and on other essential matters such as account statements.
Section Five – Declaration
* Required Fields
I hereby apply for membership of, and agree to abide by the rules of, Northamptonshire Credit Union. I declare that the information given by me on this form and in support of my membership application is true and correct to the best of my knowledge and belief.
Signature: *Signature
On receipt of your application, Northamptonshire Credit Union will conduct an online check of your identity and address. Please note that this is not a credit check. In the event that we are unable to verify your details through the online check, we will need to see proof of your identity and address in order to complete the opening of your account.
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Northamptonshire Credit Union Tel: 01604 250016 Email: Web:
Northamptonshire Credit Union is authorised by the Prudential Regulation Authority & regulated by the Financial Conduct Authority & the Prudential Regulation Authority (FRN 213810)