BET FEDERAL CREDIT UNION

                                                                                                                                           

  P.O. Box 474

                                                                                                                            

Bronxville, New York 10708

                                                                                                         

MEMBERSHIP APPLICATION

Name: ______________________________________________________________

Home Address:
Street:_______________________________________________________________

City ________________________State ___________________Zip ______________

Home Phone (Include Area Code) _________________________________________

Birth Date ____________________________________________

Social Security #:__________________________________

School District _________________________________________

School Phone __________________________________________

Position _______________________________________________

Spouse's Name:  Husband's First ___________________________

                            Wife's Maiden ____________________________

If you wish a joint account, give the social security number and birth date of the joint owner.****



Birth Date _______________________________________________________________________



If you wish a payroll deduction for savings, indicate the amount per pay period $______________



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Return the completed application to the BET at the above address.


Upon receipt of  your application, the treasurer will be in touch with  you to complete
your application for membership.