Membership Application Referral Code (optional) I/We authorize Mill Town Credit Union to open the following accounts: Share (Savings) - Required Certificate of Deposit Checking IRA Share Money Market Summer Saver Owner Information Last Name First Name MI SSN Date of Birth (mm/dd/yyyy) Mother's Maiden Name Address (Do not use P.O. Box) City State Zip Code Email Address Home Phone Cell Phone () -Second partThird part () -Second partThird part Work Phone Ext. # () -Second partThird part Photo ID Type Issue Date of ID (mm/dd/yyyy) Expiration Date of ID (mm/dd/yyyy) Please Choose... State Drivers License State ID US Military ID US Passport ID # State of Issuance Owner Employment Info Employed By Employer Address Occupation Membership Eligibility Our membership is open to anyone who works, lives, worships or goes to school in the following school districts in the State of Washington. If you are eligible through a family member, please tell us the name of the Mill Town Credit Union member and their relation to you: Name of Member Relationship Joint Owner Information Last Name First Name MI SSN Date of Birth (mm/dd/yyyy) Address (Do not use P.O. Box) City State Zip Code Email Address Home Phone Cell Phone () -Second partThird part () -Second partThird part Work Phone Ext. # () -Second partThird part Photo ID Type Issue Date of ID (mm/dd/yyyy) Expiration Date of ID (mm/dd/yyyy) Please Choose... State Drivers License State ID US Military ID US Passport ID # State of Issuance Joint Employment Info Employed By Employer Address Beneficiaries Upon death of the last surviving account holder, the balance in this account shall be paid to: Beneficiary Name SSN Phone () -Second partThird part Address City State Zip Beneficiary Name SSN Phone () -Second partThird part Address City State Zip Mill Town Credit Union Can Help Save You Money! Tell me how Mill Town Credit Union can help me save money on my existing auto loan with another lenderTell me how Mill Town Credit Union can help me save money on refinancing my current mortgageTell me how Mill Town Credit Union can help me lower my credit card payments and/or interest rate Electronic Submission Being within the field of membership, I/we hereby apply for membership in the Mill Town Credit Union and agree to conform to its bylaws and amendments thereto; subscribe for at least one share; and agree to the conditions printed in this form. By clicking submit below, I/we agree to be bound by the Mill Town Credit union's bylaws, and all rules, regulations, terms and conditions governing this account, and all amendments thereto which may be in effect from time to time. I have read and accept the Membership Agreement and Disclosures. Mill Town Credit Union is hereby authorized to recognize any of the signatures subscribed hereto in the payment of funds or the transaction of any business for this account. I/We authorize you to obtain information about me/us from credit reporting sources, and report my/our experience with this account to credit bureaus and others who may inquire about my/our experience with this account. You may also request or use subsequent consumer reports in connection with a review, update, renewal or extension of my/our accounts without additional notice to me/us. USA Patriot Act 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. Prior to submitting this application, please enter the security code in the box below