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Secure Membership Sign Up Form

2540 Olentangy River Road, Columbus, OH 43202
Phone: (614) 447-3675 • Fax: (614) 447-3824

1155 16th Street, NW, Washington, DC, 20036
Phone: (202) 452-8915 • Fax: (202) 776-8221

How To Join:
  1. Complete the following On-Line Membership Application Request Form and submit it.
  2. Once recieved, we will mail to you a Membership/Signature Card for your signature and signature(s) of your joint owner(s) (if applicable).
  3. The signed Membership/Signature Card must be returned to the credit union along with an initial deposit of at least $5.00, plus a $1.00 initial setup fee, and a copy of a government issued photo ID for the application process to be completed.

The Membership/Signature card you will sign includes the following statements and agreements:

I hereby make application for membership in American Chemical Society Federal Credit Union (ACSFCU), and agree to conform to its bylaws and amendments thereof, and to subscribe for at least one (1) share. The ACSFCU is hereby authorized to recognize any of the signatures subscribed hereto in the payment of funds or the transaction of any business for this account. The joint owners of this account hereby agree with each other and with ACSFCU that all sums now paid in on shares, or heretofore or hereafter paid in on shares by any or all of said joint owners to their credit as such joint owners with all accumulations thereon, are and shall be owned by them jointly, with right of survivorship and be subject to the withdrawal or receipt of any of them, and payment to any of them or the survivor or survivors shall be valid and discharge said conditions of the account as established by the ACSFCU from time to time. Any or all of said joint owners may pledge all or any part of the shares in this account as collateral security to a loan or loans from this Credit Union. The right, or authority of the ACSFCU under this agreement shall not be changed or terminated by said owners, or any of them, except by written notice to ACSFCU which shall not affect transactions theretofore made.

Under the penalties of perjury, I certify (1) that the number shown on this form is my correct taxpayer identification number and (2) that I am not subject to Backup Withholding either because I have not been notified that I am subject to back up withholding as a result of a failure to report all interest or dividends, OR The Internal Revenue Service has notified me that I am no longer subject to backup withholding, and (3) I am a U.S. citizen (including a U.S. resident alien).

Mortgage Information
Your Email Address:
First Name: MI:
Last Name:
Social Security Number:
Street Address:  
Home Phone #: 1234567890 (no separators)
Business Phone #:

Membership Eligibility

(Check all that apply):
Employee or Retiree of American Chemical Society, its Divisions or Tenant Organizations
Related to Current Member

How did you hear about us?
Employee Orientation
MoneyMatter$ Newsletter
Friend/Family -  Name:
Member/Co-Worker -  Name:

Submit Application

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