Print this document from your browser (File|Print). Complete, sign and return this application to any AFFCU office. Fax to Member Services at 210.678.5291. Or mail to Member Services, Air Force Federal Credit Union, 1560 Cable Ranch Road, Suite 200, San Antonio, TX 78245.

Member Name ___________________________________________________

AFFCU Account Number _____________________________________________

Address _________________________________________________________

City/State/Zip ____________________________________________________

E-Mail Address ____________________________________________________

Home Phone (       ) _______________  Work Phone (        ) _______________

Name(s) of Cardholder(s): (Must be a Primary Member or Joint Owner)

__________________________________________________________

__________________________________________________________

Agreement
I hereby make application for a Air Force Federal Credit Union ("AFFCU" or "Credit Union") VISA Check Card to access the accounts indicated above. I will select my/our Personal Identification Number (PIN) and be responsible for keeping it a secret. I will not write it on anything, tell my PIN to anyone, or allow anyone to watch when using it. In addition, I hereby authorize you to provide a Check Card to the Joint Owner(s) named on this application. I am aware and agree that any joint owner may obtain and use The Check Card on this account. I further understand that when using another financial institution’s ATMs, I may be charged a fee by them for using their ATM. If I am charged a fee, it should be disclosed by the institution prior to completing any transaction and, that by completing my transaction, I am agreeing to the fee being charged. I also understand that I will be charged a fee by AFFCU when using an ATM not owned by the Credit Union.

I certify that all of the information I have provided above is true and complete. By signing below, I agree to be bound by the Air Force Federal Credit Union Electronic Fund Transfers (EFT) Agreement and Disclosures which detail my liability and responsibility in the use of the Card and for reporting the loss or theft of the Card. I understand that the EFT Agreement and Disclosures will be provided to me before I receive The Check Card. I further agree that my use of the VISA Check Card is subject to the Credit Union’s Account Agreement, rules, policies, and bylaws now in effect and as amended from time to time. I understand that the Credit Union may request a consumer credit report in connection with this application.

Signature of Primary Member or Joint Owner_____________________________ Date __________