Primary Account Owner Information

Primary Account owner Email Address: (example: [email protected])
First Name: (example: John)
Middle Initial: (example: Q)
Last Name: (example: Public)
Applied Industrial Technologies Location No.: (if applicable): (example: 0100)
Applied Industrial Technologies Payroll No.: (example: 046749 - appears on your check stub to the left of "Pay Period Ending")
Security Code: (example: go4it - your secret code you select, may be any combinations of numbers and/or letters MUST BE 5 CHARACTERS)
Date of Birth:
 Month   Day    Year
Residence Address 1: (example: 3615 Euclid Ave)
Residence Address 2: (example: Suite 1B)
City: (example: Cleveland)
State Abbreviation:Select State
Home Phone: (example: 216-432-3230)
  -   - 
Social Security Number: (example: 345-12-1234)
  -   - 
Applied Industrial Technologies Hire Date: Select Month, Date, and Year
  Month   Day    Year
Occupation: (example: Service Center Manager)
Mother's Maiden Name: (example: Mae Owens - used as an alternate security code)
Driver's License State, Number, and Expiration Date: Select State and Type in Number
  State
Driver's License Number: (example: RH451133)
Driver's License Expiration Date: Select Month, Date, and Year
  Month   Day    Year


Joint Account Owner Information


First Name: (example: John)
Middle Initial: (example: Q)
Last Name: (example: Public)
Social Security Number: (example: 345-12-1234)
  -   - 


Any Comments You Want to Send:

 

When you click on the submit button, you are sending to an email address. Please be assured that the information is being sent to the Credit Union Office [email protected]. The only individuals that can see this message are Credit Union Office personal. If you are concerned in any way about submitting any of this information then you can use the Membership Forms Page to download the forms and mail them to the Credit Union at the address listed on that page. If you like you can also click the print button on your Internet browser tool bar. Print a copy of this web page form, after you have completed all necessary fields on-line, but not clicking on the submit button, and mail it to the Credit Union Office.

I hereby make application for membership in the Industrial Distributors Federal Credit Union and agree to its laws and amendments thereof and subscribe for at least one share. Any account opened in more than one name shall be a joint account with rights to survivorship. If you have established a joint account, both owners agree to conform to the Credit Union's bylaws and any amendments. If you return this application electronically, we may ask you to sign a hardcopy of this application at a later date.



I am interested in the following services and request the Credit Union send me more information. Please check the appropriate boxes.

 ATM Card 
 Visa Credit Card 
 Share Draft/Checking Account 
 Vacation/Christmas Club Account 
 LoanLiner Application 
 Share Certificates 
 Direct Deposit 
 Prepaid Legal Service 


  




 

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