NOTEWORTHY FCU                                                        Checking Account/ATM Application
1900 Superior Avenue Suite #126
Cleveland, OH 44114
(216)263-7034

                                             Member Application

Member___________________________________________     Account No.___________

Joint Owner___________________________________________      Account No.___________

Address________________________________________________

City____________________________     State______     Zip__________

Employment________________________________________________

Social Sec. No.____________________     Driver's License No.____________________

Phone-HM (_____) _____-__________       WK (_____) _____-__________

Cell (_____) _____-__________     Email___________________________________

Birthdate______________________________

By signing below, I/we agree to the terms and conditions of the Membership & Account Agreement, Truth-in-Savings Rate & Fee Schedule, Funds Availablity Policy Disclosure, if applicaple, and to any amendment the Credit Union makes from time to time which are incorporated herein. I/we acknowledge receipt of a copy of the Agreement & Disclosure applicable to the accounts and services requested herein. If an access card or EFT service is requested and provided I/we agree to the terms of and acknowledge receipt of the Electronic Fund Transfer agreement. Signature:___________________________________________     Date:___________ Joint Owner Signature:_________________________________     Date:___________

                                             Account Services

_____Payroll Deduction/Direct Deposit                                        _____ATM Card

_____Overdraft Protection (Line of Credit)*                                _____Debit Card

_____Other                                                                                 _____EFT Service

*Please Indicate first & second transfer priority _____Shares _____Line of Credit