New Member Application Online

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What Do I Need?

Taxpayer Registration Number (TRN)
Proof of Valid Identification - Jamaican Driver’s Licence or Jamaican Voter’s ID ONLY
- The back and front of your ID must be uploaded

Proof of Address
Any one of the following:
- Jamaican Driver’s Licence
- Utility bill in your name no older than six months
- Voter’s ID
- A post marked envelope no older than six months addressed to you

Proof of Income/Employment
- Pay slip or job letter, either of which should be no older than six months as at the date of application

Contact details for two referees
Minimum amount to purchase shares JMD $9,000.00

(duplicate)

Applicants Information

Sex *

Marital Status *

Title *

Date of Birth *

Tax Registration Number

First Name

Middle Name

Surname

Maiden Name

Alias

Telephone Number (Home)

Telephone Number (Cell)

Telephone Number (Fax)

Email Address

Current Address

Current Home Address: (Street)

City/Town/District/P.O. Box/Postal Zone/Zip Code:

Parish *

Country *

Nationality *

Place of Birth *

Residential Status *

Number of Dependent(s)

Age of Dependent(s)

Time at this address

Years

Months

Mailing Address (Skip If Same As Current Address)

Enter Mailing Address If Different From Address Above

Mailing Address

City/Town/District

P.O. Box/Postal Zone/Zip Code

Parish *

Country

Previous Home Address: (Street)

City/Town/District

P.O. Box/Postal Zone/Zip Code:

Country

Applicant's Identification Information (For Child)

Adult Applicant & Parent/Guardian of Child

Identification Type *

ID Number *

Expiry Date *

Child Applicant

Identification Type(duplicate)

ID Number

Expiry Date

Employment Status & Other Information

Occupation/Job Titlethe terms “business man/woman – manager” are not acceptable

Employment Status

Do you hold a prominent public position such as senior civil servant, politician, senior police or army officer?YesNo

Position Held

Are you immediately related to or closely associated with any of the above-mentioned positions?YesNo

Are you related to an employee, relative or volunteer of the Credit Union?YesNo

Name *

Relation *

Name of Employer/Business/School

Telephone Number

Employed/Attending School Since

Employer/Business/School Address

City/Town/District

P.O. Box/Postal Zone/Zip Code

Parish

Country

Source of Funds

Annual Salary/Income: ($)

Currency: (for Income Received)

Expected Deposit Amount

Annually

Monthly

Fortnightly

Weekly

Citizen Information

Are you a citizen of the United States of America? *YesNo

Are you a United States of America Green Card holder? *YesNo

Were you born in the United States of America? *YesNo

Are you a United States of America Resident? *YesNo

Other country apart from Jamaica and the United StatesYesNo

What is the name of the country? *

Address: (Street)

City/Town/District

P.O. Box/Postal Zone/Zip Code

Telephone Number

Verification of Address

Recent original utility bill in the name of the applicant
OR
Recent correspondence [within the last three (3) months] in the applicant’s name and bearing the same address (from government, financial institution or place of employment)

Family Information

Title *

Sex *

Marital Status *

Date of Birth

T.R.N.

First Name *

Middle Name

Surname Name *

Maiden Name

Relation to Applicant *

Email Address

Current Home Address: (Street) *

City/Town/District *

P.O. Box/Postal Zone/Zip Code

Parish *

Country *

Nationality *

Telephone Number: (Home)

Telephone Number: (Cell)

Telephone Number: (Work)

Telephone Number: (Fax)

Occupation/Job Titlethe term business woman/man are not acceptable

Employment Status

Employer Name/Business

Employed Since

Address of Employer/Business

City/Town/District

P.O. Box/Postal Zone/Zip Code

Parish

Country

Actual Yearly Salary/Income

Is the spouse/parent/guardian expected to make lodgements to this account?YesNo

What is the Source of Funds? *

How Else Can We Contact You?
(nearest relative NOT Living with you)

Title *

Sex *

Marital Status *

Date of Birth *

T.R.N. *

First Name *

Middle Name

Last Name

Maiden Name

Alias

Relation to Applicant *

Current Home Address *

City/Town/District *

Parish *

Country *

Nationality *

Name of Employer/Business/School

Occupation/Job Titlethe terms "business man/woman, manager" are not acceptable

Telephone Number: (Home)

Telephone Number: (Cell)

Telephone Number: (Work)

Employer/Business/School Address

City/Town/District

P.O. Box/Postal Zone/Zip Code

Parish

Country

Information for Reference(s)
reference(s) will be contacted

Acceptable References include: □ Credit Union Board/Committee Member □ Credit Union Employee at supervisory level, employed for more than one (1) year □ Police Officer (Rank of Inspector or Higher) □ Credit Union Member for more than two (2) years and in good standing □ Manager of another Financial Institution where the applicant has an account in good standing (letter must state same) □ JP/Notary Public □ Medical Doctor □ Attorney-at-Law □ Principal □ Minister of Religion □ Employer (HR Manager or Higher)

Reference 1

Title *

First Name *

Middle Name

Surname *

Type of Reference *

How long have you known the applicant *

Current Home Address *

City/Town/District *

Parish *

P.O. Box/Postal Zone/Zip Code

Country *

Nationality *

Name of Employer/Business/School

Occupation

Telephone Number: (Home)

Telephone Number: (Cell)

Telephone Number: (Work)

Employer/Business/School Address

City/Town/District *

P.O. Box/Postal Zone/Zip Code

Parish *

Country *

Reference 2

Title *

First Name *

Middle Name

Surname *

Type of Reference *

How long have you known the applicant *

Current Home Address *

City/Town/District *

Parish *

P.O. Box/Postal Zone/Zip Code

Country *

Nationality *

Name of Employer/Business/School

Occupation

Telephone Number: (Home)

Telephone Number: (Cell)

Telephone Number: (Work)

Employer/Business/School Address

City/Town/District

P.O. Box/Postal Zone/Zip Code

Parish *

Country *

What Do I Need?

Applicants Information

Current Address

Mailing Address (Skip If Same As Current Address)

Applicant's Identification Information (For Child)

Employment Status & Other Information

Citizen Information

Verification of Address

Family Information

How Else Can We Contact You? (nearest relative NOT Living with you)

Information for Reference(s) reference(s) will be contacted

How Else Can We Contact You?
(nearest relative NOT Living with you)

Information for Reference(s)
reference(s) will be contacted