Card Type

  • Card Type

    OKCard Type is required

Personal Information

  • OKName is required
  • OKAccount Number is required
  • Social Security Number

    OKSocial Security Number is required
  • Date of Birth

    OKDate of Birth is required

Contact Information

  • OKEmail is required
  • Phone Number

    OKPhone Number is required
  • Work Phone Number

    OptionalOKWork Phone Number is required
  • OKAddress is required
  • OKCity is required
  • OKState is required
  • OKZip is required

Joint Account

  • OptionalOKJoint Account Holder is required
  • Date of Birth

    OptionalOKDate of Birth is required

Card Information

    OKYes, I would like to receive a Northern Skies FCU VISA Check Card and a PIN (Personal Identification Number) to be used with my card. is required
  • With a Northern Skies FCU VISA Check Card, you can access your checking, savings, and/or your Line of Credit accounts from just about anywhere 24 hours a day, 7 days a week. Please indicate which accounts you would like to access with your new card below.

  • Accounts

    OKAccounts is required
  • I (We) request a Northern Skies FCU VISA Check Card and Personal Identification Number (PIN) to be used with the card to access the account(s) as I (we) have indicated above. I (We) certify that the information I (we) have provided is true and complete and made for the purpose of obtaining credit. If necessary, you may obtain information from any credit reporting agency and may report your experience with my (our) account. By signing this application, I (we) acknowledge that all signers of this application are liable for the account and by accepting or using the card, I (we) agree to the terms and conditions of the Electronic Funds Transfer Agreement (as found in the "Important Account Information for Our Members" booklet) provided to me prior or with my (our) card.

    OKI/We agree to the above statement is required

Security Code

  • OK is required