Membership Form
508 National Avenue. P.O. Box 3490. Chattanooga, TN 37404
Phone: (423) 629-2578  •  Fax: (423) 624-0987


How To Join
  1. Complete the following On-Line Membership Application Request Form and submit it.
  2. Once received, we will mail to you a pre-filled application form requiring your signature and the signature(s) of your joint owner(s) (if applicable).
  3. The signed Membership application must be returned to the credit union along with an initial deposit of at least $5.00 and / or direct deposit form, 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 Southern Credit Union (SCU), and agree to conform to its bylaws and amendments thereof, and to subscribe for at least one (1) share. The SCU 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 SCU 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 SCU 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 SCU under this agreement shall not be changed or terminated by said owners, or any of them, except by written notice to SCU 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).



Applicant Information
First Name: MI: Physical Address :
Last Name: City : State:
Date of Birth: Zip :
Mother's Maiden Name: Mailing Address :
Social Security #: City : State:
Driver’s License # : Zip :
Driver License Issue Date : Home Phone :
Driver License Expiration Date : Business Phone :
Driver License State of Issue : Employer:
Email Address : Occupation / Title:

Beneficiary(s)
Name Social Security Relationship











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Member/Co-Worker -  Name:
Other:

Submit Application

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Date:
Primary Signature:
Joint Signature:
Enter The Security Code Displayed In The Box Below:
[858932]