Credit Card Application

Are you a current member of BlueOx Credit Union?

Yes

No

If yes, provide account number here.

You will need to become a member to open a BlueOx Credit Union Credit Card. After you submit this form, a BlueOx Credit Union Member Service Advisor will contact you about opening an account.

First Name *

Last Name *

Birthday *

Social Security *

Personal Information

Employer Name *

Employer Start Date *

Job Title *

Annual Income *

Address Line 1 *

Address Line 2

City *

ZIP Code *

Rent, own, or live with others *

monthly housing payment *

Years at residence *

Phone *

Reference 1 Name *

Ref 1 Phone Number *

Ref 1 Relationship *

Reference 2 Name *

Ref 2 Phone Number *

Ref 2 Relationship *

Co-Applicant:

Add Co-Applicant?

Yes

No

Coapp First Name

Coapp Middle Initial

Coapp Last Name

Coapp Birthday

Enter Social Security

Coapp Employer Name

Coapp Annual Income

Coapp Address Line 1

Coapp Address Line 2

Coapp City

Enter ZIP Code

Coapp Phone

Credit Card Information

Credit Limit Requested *

Do you have balances on other credit cards that you would like to transfer to your new BlueOx Credit Union Credit Card, if approved? *

Yes

No

If yes, please enter the card number, balance, creditor and payoff address.

Disclosures

I/We authorize BlueOx Credit Union to pull my/our credit for the purposes of qualifying me/us for credit. I/We also certify, by checking the box to the left that I/we have read and understand the disclosures above. We may contact you in relation to this application for additional information and other potential savings we may have available for you.

Please click the "Submit" button below to confirm your credit card application was submitted.

Submit