Account Registration

New Member Account Registration

* Indicates required field

Date *

Prefix *

First Name *

Last Name *

MI *

Suffix *

Email *

Phone Number *

Date of Birth (DOB) *

Driver's License/ State ID *

Social Security Number *

Mailing Address *

City/State *

ZIP Code *

Employer Name/Occupation *

AME Church/Personal Affiliation *

Beneficiary *

I hereby certify. *

Yes, I want to become a member of the Imperial Credit Union. Minimum amount to open a membership account is $30 ($20 deposit + one-time setup fee).

Consent and Legal Disclosure
By submitting this form, I affirm that the information provided is accurate and complete to the best of my knowledge. I understand that Imperial Credit Union may use this information to verify my identity, determine eligibility for membership, and comply with applicable laws and regulations. I consent to the collection, use, and secure storage of my personal data—including, but not limited to, my Social Security Number, date of birth, and employment details—in accordance with Imperial Credit Union’s privacy policy and relevant data protection laws.
I further acknowledge that by entering my name in the Electronic Signature field, I am providing my legally binding electronic signature. This signature carries the same legal weight and enforceability as a handwritten signature. I confirm that I am the individual named in this application and that I authorize Imperial Credit Union to process my request for membership and related services.

Electronic Signature *

Submit