MUW Federal Credit Union -- Secure Home Banking Sign Up Form

	1100 College Street W-41 Columbus MS 39702 Phone: 662-327-2500
	*Secure Home Banking Sign Up Form*

You must currently be a MUW FCU member to complete this form!
The information requested below is for the primary member on the account.

All Fields Are Required

Your Member Acct. Number:
Your Email Address:
First Name:
Middle Name or Initial:
Last Name:
Street Address:
City:
State:	Zip:
Home Phone #:
Cell Phone #:
Work Phone #:	Ext:
Last 4 of Social Security #:
Birthdate (MM/DD/YY):

By submitting this request, I hereby request online access to my accounts. I understand that each of my accounts at MUW Federal Credit Union is governed by the applicable account disclosure/agreement & Truth In Savings disclosure I received when I opened the account.