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legal / Additional

Organization Type (U.S.-based Organizations Only) *— Select Choice —Credit UnionCredit Union Service Organization (CUSO)CU Trade Association (League, National Trade)

Don’t see your organization type? Your company may not be eligible at this time. Use our contact page to reach out for more information.

Current Credit Union Assets Under Management *

• Under $100M (Dues $300/year)
• $100M – $249M (Dues $600/year)
• $250M – $499M (Dues $1,200/year)
• $500M – $999M (Dues $3,000/year)
• Over $1BN (Dues $6,000/year)

A 10% discount is applied to the listed dues for the first year of membership (Must be first-time, new membership).

Current CUSO Employee Headcount *

• 1-50 Employees (Dues $1,200/year)
• 51-200 Employees (Dues $3,000/year)
• 200+ Employees (Dues $6,000/year)

A 10% discount is applied to the listed dues for the first year of membership (Must be first-time, new membership).

Current League/Trade Association Pricing *

• Dues $3,000/year

Please check the box to acknowledge single-tier pricing. A 10% discount is applied to the listed dues for the first year of membership (Must be first-time, new membership).

Primary Contact Name *

First

Last

Primary Contact Work Email *

A valid business email address is required to verify eligibility. Applications with consumer email addresses (Gmail, Hotmail, etc.) will be discarded.

Job Title *

Your current job title at the applying membership organization.

Business Information

Legal Business Name *

Legal Business Address *

Address Line 1

Address Line 2

City

— Select state —AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingState

Zip Code

For credit unions, please be sure this aligns with public NCUA or ASI data.

Business Website / URL *

To assist with verification, we recommend providing a website address in case there are other eligible member organizations with similar names.

Phone

Please provide a valid contact number in case we have questions about your application or need to verify company details.

Billing Information

Billing Contact Name *

First

Last

Billing Contact Email *

A valid business email address is required. This is where the email invoice and W-9 form will be sent.

Billing Address (only provide if different from legal address)

Address Line 1

Address Line 2

City

— Select state —AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingState

Zip Code

This is the address that will be on invoices and official billing correspondence.

Optional Information

Additional Email Contacts

Separate with a comma. These individuals will be included on future correspondence pertaining to this application.

Additional Details or Notes

Include any additional information you want us to know about your application.

Submit Your Application

DISCLAIMER: By clicking ‘Submit Your Application’ above, you confirm that you are authorized to provide this application on behalf of your organization. Submission of this form does not constitute an application approval or a binding agreement between you and our organization. Membership is subject to eligibility review and pricing verification. If approved, a separate membership agreement outlining terms and conditions will be provided for review and execution.

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