Join - Celtic Credit Union

Celtic Credit Union Membership Application

Step 1 of 4 - Your Details

To become a member of Celtic Credit Union you must complete the form below, this will take about 5 minutes and is a secured web page so you can be safe in sending us the information that we need.

Please be aware that you will need to provide us with copies of your ID before we can open your account. We will reply to your application by post within a few days, telling what you need to do next.
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I hereby apply for membership and agree to abide by the rules of the Credit Union. I declare that the information given by me on this form is true and correct to the best of my knowledge.

I understand that Celtic Credit Union will process my data in accordance with my rights under the Data Protection Act 1998.

By Signing below, I hereby allow Celtic Credit Union to order on my behalf a pre-paid debit card provided by The Change Account which will be issued to me within 10 working days to the address provided. (Terms & Conditions Apply.)
Do you agree to this disclaimer?*
- Yes, I agree
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Title
Please enter your title, eg Mr, Mrs
First Name*
Please enter your first name
Middle Name
If you have a middle name please enter it here
Surname*
Please enter your last name here
Your Address*
Street Address Address Line 2 City County / State / Region ZIP / Postal Code Country

Please add where you are living at present, if you have been at the address for less than 6 months please complete the other sections.
How long have you lived at this address*
Previous Address
Street Address Address Line 2 City County / State / Region ZIP / Postal Code Country
Home Telephone
Please enter your full telephone number with area code
Mobile Telephone Number
If you do not own a mobile phone please enter 000
Email Address

Please enter a valid email address, if you do not have one please enter [email protected]
NI Number*
This will be on your payslip, P45 or tax office
Gender
Please choose if you are male or female
Date of Birth*

Please enter your date of birth - Day,Month,Year

Employment Details

Please Enter details of your employment Below
Employment Status*
Please add all employment information, if applicable.
Occupation*
Employers Name
Employers Address
Street Address Address Line 2 City County / State / Region ZIP / Postal Code Country
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Beneficiary Details

Please add details of your next of kin.
Name*
Please enter their name.
Address*
Street Address Address Line 2 City County / State / Region ZIP / Postal Code Country

Please enter their address.
Contact Number*
Please enter their contact number.
Relationship
Please enter the relation between you and the beneficiary
Membership Number
Please enter their credit union membership number if you know it.

Bank Details

Please enter your bank details for payments, all information gathered on this website is only used for setting up your account.
Do you have a bank account?
Bank Name
Sort Code
This is the 6 digit number on your account ##-##-##
Account Number
This is normally shown on the bottom of your credit/debit card or statement and is not the longer number on your card.
Name of Account
Please add the name of the account holder
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Verification

For the credit union to verify who you are we ask for two official documents please select and complete.
How can we verify your details?*
Drivers Licence

Please enter the details on your drivers licence
Drivers Licence Number
Passport Details

Please enter the details on your passport
Passport Number
Expiry Date

Please state that you have read our terms and conditions and understand this agreement, our terms can be found here:

I declare that I have read and understood the information in the loan application - guidance notes and on this form, I also declare that the information that I have given on this form, to the best of my knowledge and belief, is accurate and complete.

I understand that the provision of false information is fraud and the Credit Union may take appropriate action if I am found to have deliberately provided false or misleading information.

Credit Referencing & Fraud Prevention Agencies Declaration

We may make searches about you at credit reference agencies who will supply us with credit information as well as information from the Electoral Register. The agencies will record details of any search whether or not this application progresses. Credit searches and other information, which is provided to us and/or the credit reference agencies about you and anyone with whom you are linked financially, may be used by us in our credit decisions.

Data Protection Statement

In accordance with the principles of the Data Protection Act 1998, we will use your personal details for the purpose of managing your accounts with the Credit Union. Your personal details will be treated confidentially and will only be shared with other agencies for the purposes of credit referencing and debt recovery, for which purposes we hold a Consumer Credit License.
I have read the terms and conditions*
- Yes I have read these

Celtic Credit Union Membership Application

Step 1 of 4 - Your Details

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Employment Details

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Beneficiary Details

Bank Details

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Verification

Drivers Licence

Passport Details