Form

To apply for a Leadco Community Credit Union membership account, you'll need the following information:

· Social Security Number

· Driver's License ID number (if age 16 or older and applicable)

· Proof of address

Upon completion of this membership application, we will contact you within two business days to discuss the status of your request.

United States Patriot Act

Important Information About Procedures For Opening a New Account: to help the government fight the funding of terrorism and money laundering activities, federal law requires all financial institutions to obtain, verify, and record information that identifies each person who opens an account. What this means for you: when you open an account, we will ask for your name, address, date of birth, and other information that will allow us to identify you. We may also ask to see your driver's license or other identifying documents.

Privacy Policy

Leadco Community Credit Union collects nonpublic personal information about you from the following sources; (a) Information we receive from you on applications or other forms; (b) Information about your transactions with us or others; and (c) Information we receive from consumer reporting agencies. We do not disclose any nonpublic information about you to anyone, except as permitted by law. If you decide to terminate your membership or become an inactive member, we will still adhere to the privacy policies and practices described above in the notice. Leadco Community Credit Union restricts access to your personal and account information to those employees who need to know that information to provide products or services to you. We maintain physical, electronic, and procedural safeguards that comply with federal regulations to guard your nonpublic personal information.

Membership

To qualify for membership at Leadco Community CU, you must meet one of the criteria listed. Please check one of the boxes that applies to the primary account owner.*

Resident of St. Francois County Employed in the mining, smelting, quarrying industries or in local governments, hospitals, schools or manufacturing enterprises in the counties of St. Francois, Ste. Genevieve, Iron, Madison, Washington, Dent, Crawford and Reynolds. A family member is a member of Leadco Community CU

If membership is based on family member, give family member's name:

First, Initial, Last

Primary Account Holder Information:

First Name*

Middle Initial

Last Name*

Address*

City, State, Zip*

e-mail address

Home Phone Number*

Cell Phone Number

Best Method of Contact

Social Security Number*

Date of Birth*

Account Ownership*

Individual Joint Beneficiary

Joint or Beneficiary Account Owner Information:

First Name

Middle Initial

Last Name

Address

City, State, Zip

Social Security Number

Date of Birth

There is no cost to join Leadco Community Credit Union. Only a $25 membership deposit is required to start your share savings account. Please select your deposit options below.

I would like to make my first deposit by:*

Cash Check Transfer from existing Leadco account

Transfer Account Number

I would like to apply for a Leadco Community CU FREE Checking account.

Yes No

I would like to apply for a FREE Leadco Community CU Debit/ATM Card.

Yes No

I would like to enroll in Leadco's FREE Internet Banking.

Yes No

I would like to enroll in Leadco's FREE electronic bill pay service.

Yes No

I would like to enroll in Leadco's FREE on-line statement. You will no longer receive your paper statement. Go green, save paper!

Yes No

Please verify that all of the information that you have entered is correct.

If you are certain the information provided is correct, click Submit to complete your application.

Membership Application