Adult Membership Application

Please fill out the form below to become a member of Leicester Credit Union.

Application for Junior Membership

Details of the junior member (under 18). Must be signed and dated by the person opening the account (trustee).

Forename(s)

Surname

Multi-line address

Country/Region

Address

City

Zip / Postal code

Tel.

Date of Birth

Day

Month

Year

Occupation

I hereby apply for membership of and agree to abide by the rules of Leicester Caribbean Credit Union Limited, and declare that the information given by me on this form is true and correct to the best of my knowledge and belief.

Provide details of previous Credit Union Membership(s)

Signed

Date

Form of Nomination

A member of Leicester Caribbean Credit Union Limited hereby nominate:

Nominated Name

Membership No.

As the person to whom there shall be transferred upon my decease such property in the credit union as may be mine at the time of decease, whether in shares or otherwise.

Dated

Day

Month

Year

Signature