Youth Account Application

Please print and complete this application and mail it to Atlantic Federal Credit Union, 37 Market St., Kenilworth, N.J. 07033. Enclose a $25 check or money order as your initial deposit and a copy of the youth's Social Security card.

Youth Account

Youth's Name_____________________________

Soc Sec No._________________________

Street________________________

City_________________ State____ Zip________

Home Phone Number______________________

Date of Birth_____________________

Mother's Maiden Name_______________

Ownership Type (check one):

___ Individual  ___ Joint Member  

___ Custodian for minor  ___ Revocable Trust

___ Payable on Death (List Name & Address of Beneficiary Below)

__________________________________________________________
Custodian's Name________________________

Custodian's Account Number________________________

Soc Sec No.__________________

Street_______________________________

City____________ State_____ Zip________

Home Phone Number________________________

Date of Birth____________________

Custodian's Signature & Date_______________________________________________

Sign me up for E-Statements! Send my statements electronically to my email address rather than mailing me a paper statement.
Yes____ No____

Send me the Credit Union's FREE periodic Electronic Newsletter that contains fast breaking credit union news and advance notice of special credit union promotions.
Yes____ No____