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Tel: 0141 445 0022 Fax: 0141 440 2294 Email: admin@nhscreditunion.com

26 July 2017
Membership Application

Are you ready to join our financial family?

  1. Have you checked your eligibility? (Application for the NHS Credit Union is open to NHS Employees in Scotland, North England (North East, North West and Yorkshire & Humberside) and their families living at the same address.)
  2. Have you read our terms and conditions? (All applicants must confirm that they have read the terms and conditions and agree to abide by them.)
  3. Have you read and understood the protection offered by the Financial Services Compensation Scheme.

Once you've checked these items, simply fill in the application form below and click submit form when you are done.
An original signature is needed by payroll departments and banks, so once we have received and checked your application form, we shall post you out either a payroll deduction mandate or a direct debit mandate if payroll deduction is not available to you.
Next complete the mandate, ensuring you insert the amount you want to save, and whether those payments will be weekly or monthly. Then sign and return it, as soon as possible, in the pre-paid envelope we shall supply.

We look forward to welcoming you into our financial family.

Please complete all your details in the form below, and click submit when you have finished.

Membership 2017
* Required Fields
Please ensure you complete all the required sections
Membership Application
* Required Fields
Have you ever been a member of the NHS Credit Union before: *Yes
No
How did you hear about our services: *
Personal Details
* Required Fields
Title: *
First Name: *
Surname: *
Address: *
Post Code: *
Date of Birth: *
National Insurance Number: *
Please enter the code shown:
*
Helps prevent automated form submissions.
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Contact Details
* Required Fields
We require your mobile telephone number and email address to ensure you receive important communications about service changes
Mobile Telephone Number: *
E-Mail Address: *
Home Telephone Number:
Designation of Beneficiary
* Required Fields
In the event of my death, I nominate the following as the person to whom there shall be transferred such property in the Credit Union as may be mine at the time of my death, whether in shares or otherwise.
Nominee First Name: *
Nominee Surname: *
Relationship to you: *
Address of Nominee: *
Post Code: *
Work Details
* Required Fields
Health Authority (Eg - NHS Ayrshire): *
Job Title: *
Ward/Department: *
Hospital:
Work Address: *
Post Code:
Work Telephone Number:
Bank Details
* Required Fields
Please provide details of the bank account where you would like payments from your credit union account to be made.
Bank Name: *
Bank Address: *
Sort Code: *
Account Number: *
Tax Residence
* Required Fields
I confirm that I am a full time resident and taxpayer in the United Kingdom: *Yes - Please enter United Kingdom in the box below
No - Please enter country of residence and where taxes are paid in the text box below
Country of residence and where taxes are paid: *
Marketing Information
* Required Fields
To ensure you receive up to date marketing information and details of product and service offers from the NHS Credit Union we need to obtain your express permission that you are happy to receive such communication either in hard copy format or electronically.
Please tick the YES box below if you agree to this request. If you do not wish to receive marketing communications as stated then please tick the NO box.
Please note we are bound by regulation to issue regular statements of all accounts held and these will continue to be issued unless there is a formal request not to receive such documents. This can be done by contacting the office directly.
Information: *Yes
No
Declaration
* Required Fields
I accept the account information and conditions of membership as detailed as part of this application: *Yes
I have read and understood the UK FSCS information contained within the terms and conditions: *Yes
I agree to having my identity and address checked: *Yes
I authorise the Credit Union to make whatever enquiries are deemed necessary to process this application: *Yes
I confirm that the information supplied on this form is, to the best of my knowledge, correct, and that I meet the NHS Credit Union Common Bond criteria: *Yes
Full Name: *
Date: *
Comments
* Required Fields
Please use this space to add any comments or additional information (if required):
Office Use Only
* Required Fields
To be completed by Credit Union staff
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Member NumberProcessed ByDate
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NHS Credit Union Limited Tel: 0141 445 0022 Fax: 0141 440 2294 Email: admin@nhscreditunion.com Web: http://www.nhscreditunion.com
NHS (Scotland & North England) Credit Union Ltd is Authorised by the Prudential Regulation Authority and regulated by the Financial Conduct Authority and the Prudential Regulation Authority. ‘NHS Credit Union Ltd’ is a registered trading name of NHS (Scotland & North England) Credit Union Ltd.