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New Member Information Form

Thank you for your interest in WESTconsin Credit Union membership! Please complete the form below, then click the Submit button. A WESTconsin Credit Union Representative will contact you to set up your personal appointment to complete your membership application.

To help the government fight the funding of terrorism and money-laundering activities, Federal law requires all financial institutions to obtain, verify and record information that identifies each person who opens an account. What does this mean to you? We will ask for your name, address, date of birth and other information that will allow us to identify you. We may also ask to see your driver's license or other identifying documents.

*=required to process your request

Primary Accountholder

This person will be the primary owner of the account and a member of the credit union

Name (First, MI, Last) *

Address *

City *   County *   State *   Zip Code *

Home Phone Number (with area code) *

Cell Phone Number (with area code)


WESTconsin Credit Union office I wish to visit:

I prefer that you respond by:


When is the best time to contact you?   At which phone number:

Products/Services I am interested in:





CALL-24 Account Access: Menomonie (715) 232-7300 | Elsewhere (888) 928-2255
To report a lost/stolen debit or credit card: (800) 449-7728

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Your savings federally insured to at least $250,000 and backed by the full faith and credit of the United States Government


National Credit Union Administration, a U.S. Government Agency