Membership Application (Single)

NOTE: To apply for membership with Cambrian Credit Union, you must be a resident of Manitoba.

Wherever you see * you must fill in that field (or select the appropriate radio button). Leaving blank any of the fields marked with the * will prevent the form from being sent, and you will have to go back and fill in the missing fields. If you do not know the answer to such a field, type UNKNOWN or ?. You may leave any of the other fields blank.

Carefully check your work before submitting this form. If you make a mistake, some browsers will reset the form if you have to go back to it, so again, please take the time to check your application over thoroughly or risk having to re-enter all your data again!
 
Select Branch Location

 * 

Personal Information of Applicant

Title
Mr. Ms. Mrs. Miss
First Name *
Middle Name *
Last Name *
Street Address *
City/Town *
Province *
Postal Code *
Home Phone # *
Fax #
Best phone number to contact me

*
Best time to call *
Email Address
Birthdate (DD/MM/YY) *
Social Insurance Number *
Employer *
How Long? *
Employer Address *
Occupation *
How Long? *
Business Phone #
Primary ID Type *
Primary ID # *
Secondary ID Type *
Secondary ID # *
Reason for opening account

*
Why did you choose Cambrian?

*
Security Question *
Security Answer *
(Identity verification when contacting your branch in the future)

Additional Information


Authorization

   I hereby make application for membership with Cambrian Credit Union Limited (hereinafter referred to as the Credit Union) and certify that the information I have provided is true and correct. I have read, understand and agree to the terms and conditions of the membership agreement provided to me.
I hereby consent to the conduct of a personal investigation by or for the Credit Union including the use of my Social Insurance Number. The personal investigation may involve enquiries from any credit bureau, as well as any current or former financial institution, lender, landlord or employer. This is to allow the Credit Union to assess my creditworthiness now and in the future. The information to be collected relates to my borrowing and repayment history and performance. The Credit Union is authorized to disclose financial information to other financial institutions, lenders or credit bureaus, on direct enquiry by any of them to allow ongoing assessment of my creditworthiness now and in the future and I agree to indemnify the Credit Union from any claims arising from any such disclosure by the Credit Union. This consent, authorization and indemnity shall continue in effect as long as my loan or membership in the Credit Union continues, even if I have later given a specific consent to a personal investigation for a particular loan or loans.

   By entering below my name and today's date and then selecting SUBMIT, I agree to all of the forgoing including authorizing the use of my personal information by the credit union as set out above.

Applicant Signature *
Date (DD/MM/YY) *


By submitting this application I am agreeing to the above conditions.