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Membership Application

There are two ways for you to apply for Membership. All applicants need to fill out the Membership Application and Membership Card. If you want to open a checking account, please fill out the Checking Account Agreement, also.

1.) ONLINE: Completely fill out the application, print it out, and bring it in to one of our 6 service center locations. Click the "Membership Card" link below the application, print it, completely fill it out, and sign it. (If you are also opening up a checking account, click on the "Checking Account Agreement" link, print it, fill it out and sign it.) Bring in the Membership Card (and Checking Account Agreement, if applicable) with at least a $5 deposit to your nearest HHCU Branch.

2.) AT A BRANCH: Stop in and see a Member Services representative at one of our 6 service centers.

 
About You
(Fields marked with * are required)

I hereby apply for membership based on the following qualification:
(Select Employee Group from this LIST, and enter in space below.)
First Name*
 Initial
 Last Name*
 Suffix (Jr., Sr., III, etc.)
Date of Birth* (mm/dd/yyyy)
 Social Security # / Tax ID*
 		   
Home Phone*
 Work Phone
ext 		     
Best time to call
 E-Mail Address*
Check one:
I currently do not have an account with Hoosier Hills Credit Union.
I am an existing HHCU member wanting to open another account.
Your Address (Do not use P O Box)
Residence Address
City
State
Zip
At this address since
/ (mm/yyyy)		      
Mailing Address (if different)
 Mailing City
Mailing State
 Mailing Zip
Identification / Security
 (When speaking with a representative by phone, you may be asked to provide this information.)
Driver's License or State-Issued ID
State
Expiration Date
 / /
Mother's Maiden Name
  
Provide one additional form of identification.    
Military ID #
 Expiration Date
/ /
Major Bank / Credit Card
 Account Number
 Expiration Date
/ /
Current Employment Information
Status
 Position / Occupation
  
Employer
 Start Date (mm / yyyy)
/ 		 
Address
City
 State
 Zip
Employer's Main Phone
( ) ext 		     
If joint membership, please enter following information
 (Fields marked with * are required)
First Name*
 Initial
 Last Name*
Suffix (Jr., Sr., III, etc.)
Date of Birth* (mm/dd/yyyy)
 Social Security # / Tax ID*
 		   
Home Phone*
 Work Phone
ext 		     
Best time to call
 E-Mail Address*
Check one:
I currently do not have an account with Hoosier Hills Credit Union.
I am an existing HHCU member wanting to open another account.
Which new accounts would you like to open?
(Choose all that apply)
Savings Checking Christmas Club 
IRAs Vacation Club ATM / Debit Card 
Money Market Direct Deposit Certificate of Deposit
Online Banking Access
Select One
I would like access to my account through the online banking system. By clicking here, I certify that I have reviewed and agree to the terms and conditions outlined in the Online Banking Access Agreement.
I do not wish to have access to my account through the online banking system at this time.
Statements
Select One
I prefer to receive my statements electronically. I understand if I later wish to stop receiving electronic statements and instead receive statements by mail, I may make this request by calling HHCU at 812-279-6644 or 800-865-2612. By clicking here, I certify that I have reviewed and agree to the terms and conditions outlined in the Online Statement Access Agreement.
I prefer to receive statements by mail.
Click for HHCU's Privacy Policy
.
Please use the space provided below for any questions or comments you may have.




Deposits Federally Insured by NCUA  Equal Housing Lender Visitors to our web site are advised that e-mail communications may not be wholly secure from interception. Please do not include confidential information such as social security or account numbers in your e-mail communications. For a secure way to send information, click here. Click to read Hoosier Hills Credit Union's Privacy Policy.