Membership Application

By completing and submitting the secure membership application below you are letting us know that you would like to open an account at Baylands Family Credit Union. You are eligible for membership if you live, work, go to school or worship in Chesterfield, Essex, Middlesex, Mathews, Gloucester, King & Queen, King William, New Kent and James City. Immediate family of current members are eligible too! Please note that a $5 minimum deposit to your Primary Share Savings Account is required. Upon submission of this application, a Credit Union Representative will contact you to determine how you would like to complete the steps to finalize your account.

Important Account Information For Your Review

Please Note: In addition to the electronic application you are about to submit, Baylands Family Credit Union requires the following in order to process a new account.

Valid Photo ID
$5.00 Deposit
Completed and signed Membership Application

Printable Membership Application

Personal Information

How did you discover Baylands Family Credit Union?

Search engine (Google, Yahoo etc)

Recommended by friend or family

Other

Last Name*

First Name*

M.I.

SSN/TIN*

Address*

City*

State*

Zip Code*

Home Phone*

Birthdate*

Email Address*

(mm/dd/yyyy)

Driver's License Number*

State*

Expiration Date*

(mm/dd/yyyy)

Mother's Maiden Name*

Eligibility

Eligibility for Membership*

Event Code (if applicable)

Employer*

Work Phone*

Employer Address*

City*

State*

Zip Code*

Important Information

Finalizing Your Application

A Member Service Representative will contact you to further determine how you would like to finalize opening your account at Baylands Family Credit Union.

IMPORTANT INFORMATION ABOUT PROCEDURES FOR OPENING A NEW ACCOUNT

To help the government fight the funding of terrorism and money laundering activities, Federal law requires all financial institutions to obtain, verify, and record information that identifies each person who opens an account - What this means for you: When you open an account, we will ask for your name, address, date of birth, and other information that will allow us to identify you. We may also ask to see your driver’s license or other identifying documents. You hereby authorize us, our employees or agents to obtain credit reports in relation to this application or during anytime you are obligated to us for the repayment of any debt, and investigate and verify any information provided to us by you.

Prior to submitting the application, please enter the security code in the box below.

Is seven > than nine? (true/false)

By clicking on the “SUBMIT” button, you affirmatively consent to conduct business electronically with Baylands Family Credit Union in connection with your online membership application and consent to the receipt of the electronic disclosures shown above.