Please fill out the fields in the form to the right. One of our representatives will contact you within one business day to complete the process.

Please view our Privacy Policy for more information.


This form supports the maximum level of encryption technology your browser allows, up to 256-bit SSL encryption to protect your personal information while it is in transit.

Credit Card Application

Personal Information

  • OK Name is required
  • Home Phone

    - -
    OK Home Phone is required
  • Cell Phone

    - -
    Optional OK Cell Phone is required
  • OK Mother's Maiden Name is required
  • Date of Birth

    OK Date of Birth is required
  • Social Security Number

    - -
    OK Social Security Number is required
  • OK Email is required
  • Are you a member?

    OK Are you a member? is required
  • OK Member Number is required

Address Information

  • OK Residential Address (Not a P.O. Box) is required
  • OK City is required
  • OK State is required
  • OK Zip is required
  • Time at Address

    OK Time at Address is required
    OK is required

Personal Reference

  • OK Name is required
  • OK Address is required
  • OK City is required
  • OK State is required
  • OK Zip Code is required
  • Phone

    - -
    OK Phone is required

Employment

  • OK Current Employer is required
  • Phone

    - -
    OK Phone is required
  • OK Address is required
  • OK Your Position is required
  • Time with Employer

    OK Time with Employer is required
  • OK Income is required

Previous Employment

  • OK Your Employer is required
  • Phone

    - -
    OK Phone is required
  • OK Address is required
  • OK Your Position is required
  • Time with Employer

    OK Time with Employer is required
  • OK Income is required

Joint Account Information

  • Number of Joint Owners on this Account

    OK Number of Joint Owners on this Account is required

Joint Applicant #1

  • OK Relationship to Primary Applicant is required
  • OK Name is required
  • Date of Birth

    OK Date of Birth is required
  • Social Security Number

    - -
    OK Social Security Number is required
  • OK Drivers License Number is required
  • OK State Licensed Issued is required
  • Home Phone

    - -
    OK Home Phone is required
  • Work Phone

    - -
    OK Work Phone is required
  • OK Residential Address is required
  • OK City is required
  • OK State is required
  • OK Zip is required

Joint Applicant #2

  • OK Relationship to Primary Applicant is required
  • OK Name is required
  • Date of Birth

    OK Date of Birth is required
  • Social Security Number

    - -
    OK Social Security Number is required
  • OK Drivers License Number is required
  • OK State License Issued is required
  • Home Phone

    - -
    OK Home Phone is required
  • Work Phone

    - -
    OK Work Phone is required
  • OK Residential Address is required
  • OK City is required
  • OK State is required
  • OK Zip is required

What We’ll Need Later

    • Last 2 pay stubs (card holder)
    • Copy of Drivers License (card holder & joint applicant)

Disclaimers

    OK By checking this box you certify that you have read and understand the terms and disclaimers associated with this application. is required

Comments

  • Optional OK is required

Security Code

  • OK is required

    State Employees Credit Union reserves the right to use the above information to obtain verifications of identity and background before opening any accounts. We may also access information about you from a consumer reporting agency, such as a copy of your credit report, before opening any account. By submitting this form, you grant full permission to do so.

State Employees Credit Union. Copyright © 2014 - All rights reserved.

Powered by BVI