Married Applicants may apply for a separate account. Check the appropriate box to indicate Individual Credit or Joint Credit.

Co-Applicant?*

Alimony, child support or separate maintenance income need not be revealed if you do not wish to have it considered.

¹You must meet the eligibility requirements for VCCU membership, and live, work, worship, volunteer or attend school in Palm Beach County. You will be required to open a savings account once your application has been approved.

²If you have been employed less than 2 years with your current employer, previous employer information will be requested from you to complete the application.

Additional information that you would like for us to know:

All the information in this application is true. I understand that section 1014 Title 18 U.S. Code makes it a federal crime to knowingly make a false statement on this application. You have my permission to check it. You may retain this application even if not approved. If this application is approved, I agree to honor the provisions of the credit or loan agreement and security agreement covering my account or loan. (If this application is for two of us, this statement applies to both of us.)

Credit Report Authorization: By submitting this Application, I authorize you to obtain my credit report for the purposes of evaluating this application and to obtain subsequent credit reports on an on-going basis in connection with this transaction, and for all other legitimate purposes, such as reviewing my accounts or taking collection action on the account.