GADIA CO-OPERATIVE CREDIT UNION

CORPORATE MEMBERSHIP APPLICATION

SECTION 1 | INFORMATION ABOUT YOUR ORGANISATION

NAME OF ORGANISATION - (as shown on your governing document)

KEY CONTACT FOR COMMUNICATION - (full name)

CORRESPONDENCE ADDRESS

SECTION 2 | INFO. ON PERSON ACTING AS THE AUTHORITY ON BEHALF OF YOUR ORGANISATION

FIRST NAME *

LAST NAME *

POSITION IN ORGANISATION *

TIME WITH ORGANISATION *

ADDRESS *

PHONE NUMBER *

EMAIL ADDRESS *