Community Partner Referral Form Please fill out this form and be sure to include what organization referred you. We will be in contact soon. * Required Fields First and Last Name: Email Address: Phone Number: Are you a member of Financial Access Federal Credit Union? Select... Yes No Referring Organization: Have you completed any financial literacy or budgeting programming? Select... YES NO Are you currently employed? Select... YES NO If yes for how long? Select... Less than 1 year 1 year-2 years 3 years-5 years over 5 years If you are not employed, do you have any alternate income sources? Select... Yes No Describe any alternative sources of income you have and how much: Select... Less than $49,999 $50,000-$99,999 $100,000-$249,999 $250,000-$999,999 Over $1M Do you currently have savings or checking account? Select... Yes No What is your current credit score? Select... 740+ 710-739 680-709 650-679 620-649 619 and below I don't know Interested in (check all that apply):: Improving Credit Financial Literacy Opening a checking account Opening a savings account Securing a debit card Securing a credit card Securing reliable transportation Access to loans Homeownership Security Code: Security Code Go to main navigation
