P.O. Box 467, Port Jeff. Sta., NY 11776
Phone: (631) 476-6581 • Fax: (631) 476-3689
Secure Membership Sign Up Form

Click here to see if you are eligible for membership at Long Island Community FCU

To take advantage of the many services offered by the credit union, you must open a share account. Simply complete a membership form and submit it. Our office will forward a membership card requiring your signature and those of joint owners if applicable. LICFCU complies with the USA PATRIOT Act (Uniting and Strengthening America by Providing Appropriate Tools Required to Intercept and Obstruct Terrorism) which requires the following information prior to the opening of a new member account; Name of individual or business, Photo Identification, Date of Birth, Address, Social Security Number. For non-citizens a passport, alien ID card, or Gov't issued photo ID will suffice. Other security information such as date of birth and mother's maiden name will be obtained on that card. Mail the card back to us with your initial deposit.

Please complete the form and submit. A membership card will be mailed to you for your signature. All new accounts verified with ChexSystems.
 
Personal Account
First Name:
Middle Name or Initial:
Last Name:
Your Email Address:
Street Address:
City:
State:
 Zip:
Home Phone #:
Social Security #:
TIN# (Business) :

Type Of Ownership
Type:
Individual Joint
If Joint, other Owner:

Business Account
Resolution:
Individual Joint
Type of Entity: Corporation
Association Club
Sole Proprietorship
Partnership
Nonprofit Organization
Other
 
I hereby make application for membership in and agree to conform to the Bylaws, as amended, of the Long Island Community FCU (the "Credit Union"). I certify that:

I am within the field of membership of this Credit Union. The information provided on this application is true and correct.
Employer:

Business Phone:
 Membership Eligibility:

Submit Application