Membership (Services) Form
180 2nd Street SW
Barberton, Ohio 44203
Phone: (330)745-8897  •  Fax: (330)745-8055

Type of Account(s)
Individual Account            Joint Account with Survivorship
Savings / Shares              Checking / Share Draft                Other:

Applicant Information
Owner Information Joint Owner Information
Full Name: Full Name:
Address : Address :
City : State: City : State:
Zip : Zip :
Social Security #: Social Security #:
Home Phone: Home Phone:
Email Address: Email Address:
Driver's License#: Driver's License#:
Date of Birth: Date of Birth:
Cell Phone: Cell Phone:
Business Phone: Business Phone:
Employer: Employer:

Beneficiary Designations
Payable on Death (POD) Account
Beneficiary / Payee: Beneficiary / Payee:
Street: Street:
City / State / Zip: City / State / Zip:
Phone Number: Phone Number:

Submit Form
I/we hereby make application for membership in New Horizon Federal Credit Union (NHFCU). I/we agree to the terms and conditions of the Membership and Account Agreement, Truth-in-Savings Disclosure, Funds Availability Policy Disclosure, if applicable, and to any amendment(s) the NHFCU makes from time to time which are incorporated herein. I/we acknowledge receipt of a copy of the agreements and disclosures applicable to the accounts and services requested herein. If an access card or EFT service is requested and provided, I/we agree to the terms of and acknowledge receipt of the Electronic Fund Transfers Agreement and Disclosure. The Internal Revenue Service does not require your consent to any provision of this document other than the certifications required to avoid backup withholding.

By pressing the "Submit Application" button below, you agree to the above statement.