USPLK Employees Federal Credit Union

July 31, 2010

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Membership Application
Name:

Address:


City:	State:	Zip Code:

Social Security Number:	Date of Birth:

Driver's License Number:	State:

Daytime Phone:	Evening Phone:	Fax:

Current Employer:

E-mail:

Membership Eligibility:
My Employer Someone in my family is a member of the USPLK Employees Federal Credit Union.
Enter any questions or comments below:

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USPLK Employees Federal Credit Union
16055 Santa Fe Trail
Leavenworth, KS 66048
Phone: 913-682-2928
Fax: 913-682-2991

This credit union is federally insured
by the National Credit Union Administration.