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Membership Application Form

I live in the bond area I work in the bond area I live and work in the bond area

Personal Details

Title

Surname

Forenames

Address

Post Code

Home Tel No

Have you lived at this address for more than three years?

Yes No

Date of Birth

National Insurance Number

Next of Kin

Full Name

Home Tel No

Address

Post Code

Relationship

I, (full Name)

being a potential member of Glasgow West Credit Union Limited hereby nominate the above named person as the person to whom there shall be transferred, on my death, whether shares or otherwise. I will advide the Credit Union in writing if there is any change to this nomination.

Employment Details

Employer

Address

Post Code

Work Tel No

Payroll Details (If Glasgow University Employee)

Title

Department

Location

Employment Ref

Frequency

Weekly Fortnightly 4 Weekly Monthly

Bank Details

Name of Bank

Address

Post Code

Name of Account (as it appears on your card)

Sort Code

Account No.

Signature

I hereby apply for membership of Glasgow West Credit Union Ltd and agree to abide by its rules. I declare that the information provided here is true and correct to the best of my knowledge and belief. I understand that a non-refundable membership fee of £3.00 will be deducted from my first payment into the Credit Union. I also understand that a £3.00 membership fee will be charged to my account four times a year.

Applicant Signature

Date

Interviewing Officer

Date

ID Provided

Membership Number Allocated

Knowingly supplying GWCU with false information could lead to loss of membership. Glasgow West Credit Union Ltd 434 Dumbarton Road, Partick, Glasgow. G11 6SB - Tel 0141 339 6868 - info@glasgowwestcu.co.uk

Membership Application Form

Personal Details

Next of Kin

Employment Details

Payroll Details (If Glasgow University Employee)

Bank Details

Signature

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Glasgow West Credit Union is authorised by the Prudential Regulation Authority and regulated by the Financial Conduct Authority and the Prudential Regulation Authority 213948. Design by Ninetwo.