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Enrollment

 

 

Membership Enrollment Form

 

Complete the enrollment form, one for each name on the account, and forward it to the credit union with a copy of your identification card. We strongly suggest you physically bring it into the office to complete the process, for your protection.  A deposit of $6.00 ($1.00 membership fee and $5.00 minimum deposit) and a signed Account Card is required to establish an account.

Membership Enrollment Form

Name:

SS / TIN:

Street:   

Additional address information: 

City:   

ST:                            Zip:  



 

Home Phone: _____________________

 



 

Home Phone: _

Home &/or Cell Phone:

Work Phone:

Mailing Address:

 Mother's Maiden Name:

City:   

ST:                           Zip:

Email:

Birth Date:

Employer:

Payable on Death Name & Relationship:

Member Eligibility Code

ILWU                                            Family

HTH                                            Family

Consolidated Amusement                Family

Hawaiian Civic Club                      Family

HOPACO—Office Max                   Family

Kaiser-Permanente                           Family

 Waimanalo Hawn' Home Assn          Family

 Princess Kahanu Estates Assn.          Family

 Papakolea Community Haw'n Home  Family

Other

With this form, a Regular Share Account will be established for the named person on this form. For additional share types, please contact the credit union.

ID:           Government                 State

ID #                              

ID Expiration:                

 

 

Please complete one form for each owner on the account.

Caution: Due to security concerns, do not email this form.

Complete and print the form to personally bring into the credit union or for mailing.

 

 

 

 

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