Membership Application

Become a Member of NSCCU

Geographic eligibility to join North Star Community Credit Union is limited to residents within 50 miles of Bottineau, Rugby or Cavalier; residents within 75 miles of Maddock or Tolna; or residents in the county of McLean, Ward or Renville.

*Indicates required field

Membership Eligibility:

Live in Geographic Area

Immediate Family Member

If you were referred by a NSCCU member, please provide their name:

Primary Applicant Information

First and Last Name:

Social Security Number:

- -

Date of Birth:

/ /

State or Government Issued ID #:

ID Issued From:

Please Upload a Photo of Your ID:

Cell Phone Number:

Home Phone Number:

Work Phone Number:

Email Address:

Physical Address

Street Address:

Street Address 2:

City:

State:

ZIP:

Mailing Address (if different than your Physical Address)

Mailing Street Address :

Mailing Street Address 2:

City:

State:

ZIP:

Employer's Name:

If there will be a Joint Applicant, please click on the arrow below to open the box and complete the Joint Applicant information. If not, skip that section and proceed to the next page of the application.

Joint Applicant Information (if applicable)

Joint First and Last Name:

Relationship to Primary Owner:

Social Security Number:

- -

Date of Birth:

/ /

State or Government Issued ID #:

ID Issued From:

Please Upload a Photo of Your ID:

Cell Phone Number:

Home Phone Number:

Work Phone Number:

Email Address:

Physical Address
(if different than Primary Applicant)

Street Address:

Street Address 2:

City:

State:

ZIP:

Mailing Address
(if different than Physical Address)

Street Address:

Street Address 2:

City:

State:

ZIP:

Employer's Name: