If you have already contacted us and decided to proceed with the formation of your own Credit Union, you can use this form to submit the details we need for the next step. If you require more details before proceeding, such as information on current price and time frame, please contact us before submitting this form.

 

Contact Person for this order:

Name :
Address :
Country :
E-mail :
Phone :
Fax :

 

Name choices for the Credit Union:
Please provide 3 different names for the Credit Union in order of preference.

First Name Choice :
Second Name Choice :
Third Name Choice:

 

Board of Directors
Please provide 3 directors below. If you wish to provide additional directors, please use the message field at the end of this form. Please provide names exactly as they appear on the directors government issued photo ID.

First Director

 
Given name(s) :
Last name(s) :
Address :
Country :
Date of birth (DD/MM/YY) :

 

Second Director

Given name(s) :
Last name(s) :
Address :
Country :
Date of birth (DD/MM/YY) :

 

Third Director

Given name(s) :
Last name(s) :
Address :
Country :
Date of birth (DD/MM/YY) :
 
Special Note:


 

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