Membership Application

Joining Our Family is easy,

and Growth is Natural.

We're happy to see you here!

Use this form to take a giant step into a more stable financial future.

Membership Application Form

PLEASE NOTE THE REQUIREMENTS FOR PROCESSING YOUR MEMBERSHIP APPLICATION:

2 valid forms of I.D, one of which must be photo identification (e.g. National I.D. card, passport or driver’s license)
Proof of Address (please refer to the relevant section below)
$5 Application fee and $50 Membership Qualifying Shares
Incomplete applications (due to missing documentation or fees) will be shredded after one month,
and applicants will need to restart the process

"*" indicates required fields

Step 1 of 4

25%

Personal Information

Name*

First Middle Last

Date of birth*

Day

Month

Year

Gender*

Male

Female

Home Phone

Mobile Phone*

Work Phone

Primary Email*

Your preferred email address.

Secondary Email

An alternate email address.

Would you like your Primary email address added to our email list?

Yes, thanks.

Country of Birth*

Please specify the country or countries of which you are a citizen:*

Current Address*

No Post Office Boxes please.

Street Address Address Line 2 City Parish

Mailing Address

If different from Current Address

Street Address Address Line 2 City Parish

Proof of Address and Identity Verification

The Credit Union must verify your address in accordance with Know-Your Customer Regulations.
Kindly submit original documents from one of the options listed below for this purpose.
Documents must have been issued within 3 months of submission to our Offices.

Utility bill, tax bill from the Barbados Revenue Authority

A statement from another financial institution with your current address e.g. Bank, Credit Union

A hire purchase statement from a recognised business establishment e.g. Massy, Cave Shepherd or Courts

Letter from the landlord (or parent in the case of someone living with parents) along with a recent rent receipt & the utility bill for the residence

Identification - (Photo ID)*

Only state-issued, national forms of identification can be accepted.

ID Number*

Expiry Date

Day

Month

Year

Identification - (Other)*

Only state-issued, national forms of identification can be accepted.

ID Number*

Expiry Date

Day

Month

Year

Marital status*

Are you a Politically Exposed Person (PEP)?*

Yes

A Politically Exposed Person (PEP) is a person who is a member of a local or foreign political party, a senior government official, a member of the judiciary, their immediate family members, or business partners.

Indicate how you are linked to this political figure.*

Employment

Family relation

Close association (professional or social) with a PEP

Other

Please identify the Politically Exposed Person.*

Employment and Income Details

What is your current employment status?*

Temporary

Permanent

Self-Employed

Unemployed

Student

Retired

Current occupation*

If self-employed, please state, e.g. Plumber, Artist, Hairdresser

Name, Address & Telephone number of employer / business*

If with current employer for less than 2 years, name, address & telephone number of past employer.

Your Credit Union Goals

Are you a former member of this Credit Union?*

Yes

What was your account number?*

Are you a member of another local Credit Union?*

Yes

Please list the Credit Union(s) here.*

Please note that your membership with the Lifetime Credit Union will be pending, subject to the receipt of written approval from the Credit Union stated above.

Consent*

I authorize Lifetime Co-operative Credit Union Ltd to apply for dual membership on my behalf from the above listed Credit Union/s of which I am a member.

Tell us about your goals with Lifetime Credit Union*

Savings

Investments

Loans

Other

Purpose of account (Please tick as appropriate):

Pay Cycle*

Weekly

Fortnightly

Monthly

MONTHLY salary or pension range.*

$0 to $1000

$1001 to $3000

$3001 to$5000

$5001 to $10,000

Over $10,000

Anticipated MONTHLY Deposits*

Source of Funds*

Salary

Pension

Investment

Other

Qualification for membership.*

Employer

Relative

Recommended

Please list the name(s) of your employer, relative or recommenders. Please also state relation (e.g. spouse) where qualification is by relative.*

Do you operate a business?*

Yes

Please specify the type of business.*

How did you find out about Lifetime Co-operative Credit Union Ltd?*

Newspaper Ad

Google Search

Television Ad

Lifetime Member

Radio Ad

Lifetime Staff

Facebook

Presentation / Promotion

Instagram

Other

Please tell us who suggested Lifetime to you.*

Uploads, Consent and Signature

UPLOAD ONE PEICE OF PERSONAL IDENTIFICATION HERE!*

Please use this dialog box to upload your first piece of identification. Both sides of your Barbados National Identification card are required.

Drop files here or

Accepted file types: jpeg, jpg, gif, png, pdf, Max. file size: 100 MB.

UPLOAD ONE PIECE OF PERSONAL IDENTIFICATION HERE!*

Please use this dialog box to upload your second piece of identification. Both sides of your Barbados National Identification card are required.

Drop files here or

Accepted file types: jpeg, jpg, gif, png, pdf, Max. file size: 100 MB.

UPLOAD A DOCUMENT AS PROOF OF YOURADDRESS HERE!*

Please use this dialog box to upload your Proof of Address. A recent utility bill, dated within the last three (3) months is required.

Drop files here or

Accepted file types: jpeg, jpg, gif, png, pdf, Max. file size: 100 MB.

I Understand That I Will Have To Pay An Administrative Fee Of $25 If This Account Is Closed Within 6 Months Of The Date Of Opening.

Please use your mouse, touchpad or screen to sign your application.*

I understand that membership applications are subject to the approval of the Board of Directors and Management of the Lifetime Co-operative Credit Union Ltd. I agree and acknowledge that this membership application may be executed by electronic signature, which shall be considered as an original signature for all purposes and shall have the same force and effect as an original signature.

Date*

Day

Month

Year

Please send my application to the office located at:*

Bridgetown

Fontabelle

Sargeants Village

Name

This field is for validation purposes and should be left unchanged.

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*Transfers to Credit Cards can no longer be facilitated

Membership Application

Joining Our Family is easy,

and Growth is Natural.

We're happy to see you here!

Use this form to take a giant step into a more stable financial future.

Membership Application Form

Personal Information

Proof of Address and Identity Verification

Employment and Income Details

Your Credit Union Goals

Uploads, Consent and Signature

Please use this dialog box to upload your first piece of identification. Both sides of your Barbados National Identification card are required.

Please use this dialog box to upload your second piece of identification. Both sides of your Barbados National Identification card are required.

Please use this dialog box to upload your Proof of Address. A recent utility bill, dated within the last three (3) months is required.

Want to secure your financial future?

1st Floor, James Fort Building,
Corner Hincks & Prince Alfred Streets, Bridgetown, Barbados

*Transfers to Credit Cards can no longer be facilitated

Membership Application

Joining Our Family is easy,

and Growth is Natural.

We're happy to see you here!

Use this form to take a giant step into a more stable financial future.

Membership Application Form

Personal Information

Proof of Address and Identity Verification

Employment and Income Details

Your Credit Union Goals

Uploads, Consent and Signature

Please use this dialog box to upload your first piece of identification. Both sides of your Barbados National Identification card are required.

Please use this dialog box to upload your second piece of identification. Both sides of your Barbados National Identification card are required.

Please use this dialog box to upload your Proof of Address. A recent utility bill, dated within the last three (3) months is required.

Want to secure your financial future?

1st Floor, James Fort Building, Corner Hincks & Prince Alfred Streets, Bridgetown, Barbados

1st Floor, James Fort Building,
Corner Hincks & Prince Alfred Streets, Bridgetown, Barbados