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CU24 VISA Debit Card Application

To apply, please complete all the requested information below, print the application and return it to us by mail or in person.

REQUIRED: All information marked with an asterisk (*) is required.

First Name: *
Middle Name:
Last Name: *
Mother's Maiden Name *
Joint Account Holder Name:   (if none, leave blank)
Account Number:   (if none, leave blank)
Date of Birth: *  (MM/DD/YYYY)
Social Security Number: *  (000-00-0000)
Driver's License or State I.D. Number:   *  State:  *
Home Phone: *  (000) 123-4567
Email Address: *
Verify Email Address: *    (enter twice to verify spelling)
Employer: *
Job Title: *
Employer Phone: (000) 123-4567
Employer Address:  

Electronic Funds Transfer and the Cardholder Agreement.

I/We hereby apply for a CU24 Visa Debit Card. By using the CU24 Visa Debit Card issued by the Credit Union upon approval of this application, I/we signify our Agreement to be bound by the terms of the Electronic Funds Transfer and the Cardholder Agreement.

I/We give my/our permission for Saco Valley Credit UInion to obtain a credit report from a credit bureau of their choice in order to obtain information to be used in conjunction with applying for a CU24 Visa Debit Card

In order to issue a card to either signer on a joint account, both owners must provide their name and click the "I AGREE" option below.

I AGREE Primary Member Name: *
I AGREE Joint Member Name:
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