Apply for Membership

(For loan applications, please see our Loans & Credit Cards section.)

Thanks for your interest in becoming a member of Coast Central Credit Union! We have New Accounts Representatives at each of our 12 member services branches who make opening an account at Coast Central an easy, pleasant experience. You may stop by any time to apply for membership.

To get started, you may fill out the following form to begin setup of your account electronically. This form is processed through a secure server, so all information will remain safe and confidential.

If you'll also be applying for a loan, use our Membership & Loan Application to apply for both on one easy form.

Please review the following qualifications to ensure you are eligible for membership. Please check at least one of the following:
       I live or work in Humboldt, Del Norte, or Trinity County.
       I have an immediate family member who is already a member.
       I have a referral from another credit union.
       I meet another eligibility option that I have discussed with Coast Central.
Please note that there are other ways you can qualify for membership as well. If you don't meet any of the above requirements, please contact us to discuss how else we might be able to qualify you.

Account Type:
             Individual Account (one member only)
             Joint Account (two or more members)


Primary Applicant:
First Name:     Initial:     Last Name:

Street Address:
City:           State:           Zip Code:

Mailing Address (if different):
City:           State:           Zip Code:

Home Phone:        Mobile Phone:
Work Phone:         Email Address:

Social Security #:     Mother's Maiden Name:

Driver's License #:      Expiration:      State Issued:

Date of Birth:        Occupation:


Joint Applicant (optional):
First Name:     Initial:     Last Name:

Street Address:
City:           State:           Zip Code:

Mailing Address (if different):
City:           State:           Zip Code:

Home Phone:        Mobile Phone:
Work Phone:         Email Address:

Social Security #:     Mother's Maiden Name:

Driver's License #:      Expiration:      State Issued:

Date of Birth:        Occupation:


Desired Services
Please choose the services you're interested in adding to your account (check all that apply):

            Basic Checking
            Interest Checking
            Visa Debit Card
            Visa Credit Card
            Online Banking
            E-Statements
            Personal Loan
            Auto Loan
            Real Estate Loan
 Preferred Member Services Branch
Please choose from the following:



A member services representative at this location will prepare the necessary documents and have them ready for you to sign.


Contact Preference
How would you prefer we contact you when your account is ready to open?



Final approval and opening of your account will take place once signatures have been obtained from all signers on the account. A $50.00 deposit to your Membership Savings account will be required at the time of opening.

IMPORTANT: Please be sure to bring the following items with you when you come in to finalize your application:
         •   Valid identification for each applicant
         •   Social Security Card for each applicant
         •   Cash or check in the amount of at least $50.00

Please read our short Patriot Act Disclosure regarding identification procedures.

You are requesting membership with Coast Central Credit Union, hereby authorizing us to gather whatever information we consider appropriate. You understand that this will assist, for example, in determining your initial and ongoing eligibility for an account. Any account opened in more than one name shall be a joint account with rights of survivorship.