Home » Membership Enrollment Form

Thank you for your interest in joining Discovery Federal Credit Union. Please complete the form below and a Discovery Member Service Representative will contact you if additional information is needed. We look forward to serving all of your financial needs. 

- denotes required fields

Account Ownership Primary Information

First Name:
Middle Name:
Last Name:
Date of Birth:
Social Security Number:
Address 1:
Address 2:
Mailing Address if different than above:
Home Telephone Number:
Evening Telephone Number:
Cellular Telephone Number:
Drivers License Number:
Drivers License State:
Mother's Maiden Name:
Current Employer:
Employer's Address:
Employer's Telephone Number:

Membership Eligibility

* How are you eligible to enroll in Discovery? (must check one of the following fields)
Member's Name: Member's Relationship to you:

Joint Owner's Information (optional)

Joint Owner's First Name:
Joint Owner's Middle Name:
Joint Owner's Last Name:
Joint Owner's Date of Birth:
Joint Owner's Social Security Number:
Joint Owner's Home Telephone Number:
Joint Owner's Evening Telephone Number:
Joint Owner's Cellular Telephone Number:
Joint Owner's Email Address:
Joint Owner's Street Address:
Joint Owner's City:
Joint Owner's State:
Joint Owner's Zip:
Joint Owner's Driver's License Number:
Joint Owner's Drivers License State:

Beneficiary Payee Designation (optional)

In the event of my death, and all other joint owners predecease me, I hereby designate the person(s) whose name(s) appears/appear below as my beneficiary/beneficiaries to receive any and all amount in this account.)

Beneficiary's Full Name:
Beneficiary's Date of Birth:
Beneficiary's Social Security Number:
Beneficiary's Telephone Number:
Beneficiary's Street Address:
Beneficiary's City:
Beneficiary's State:
Beneficiary's Zip:

If you wish to add a second beneficiary, please complete the information below.

Beneficiary's Full Name:
Beneficiary's Date of Birth:
Beneficiary's Social Security Number:
Beneficiary's Telephone Number:
Beneficiary's Street Address:
Beneficiary's City:
Beneficiary's State:
Beneficiary's Zip:

Statement Delivery Preference

Please select your preferred
Discovery statement delivery method:


Discovery Checking Account Options (optional)


Do you want a Visa Check Card?


Checking Overdraft Protection Plan - Please list, in the order preferred, which Discovery account(s) you would like Discovery to transfer funds from to clear an overdraft, if it should occur. If no accounts are listed, the default account will be your basic savings (0001) account. You may choose to list another member's account if you are a joint owner on the account.

Discovery Account Number:
Share Number:
Discovery Account Number:
Share Number:

Standard Overdraft Practices: we do authorize and pay, at our discretion, overdrafts for checks and other transactions made using your checking account number and automatic bill payments. We do not authorize and pay overdrafts for ATM transactions or Everyday debit card transactions. You must opt in to utilize this service.


Wire Transfer Personal Identification Number (PIN)

To safeguard your account, the credit union requires that you have a Personal Identification Number (PIN) to initiate wire transfers. Please choose a four-digit PIN to use when initiating wire transfers from your credit union account.

Certification for Taxpayer Identification Number and Account Agreement

USA Patriot Act Section 326 Customer Identification Program and New Enrollment Notice & Verification Disclosure. As required by the USA Patriot Act of 2001, which requires Discovery Federal Credit Union to help the government fight the funding of terrorism and money laundering activities, Discovery Federal Credit Union must obtain basic identifying information from you and verify that information when you open a new account. This means Discovery Federal Credit Union will ask you for some basic information, such as your name, address, date of birth and other information designed to help us identify you. Discovery Federal Credit Union may also ask to see documents identifying you, such as a driver's license, passport, or some other government-issued document. Discovery Federal Credit Union appreciates your patience and understanding as we do our part in complying with the new account identification procedures required by the federal USA Patriot Act of 2001.

> Under penalty of perjury, I/We certify that:
A. Certification of Taxpayer Identification: (1) the number on this form referenced above is my/our correct Social Security number(s)/taxpayer identification number(s) (TIN); (2) I/we am not subject to backup withholding because: (a) I/we am exempt from backup withholding; or (b) I/we have not been notified by the Internal Revenue Service (IRS) that I/we am subject to withholding as a result of a failure to report all interest or dividends; (c) the IRS has notified me/us that I/we am no longer subject to withholding; and (3) I/we am a U.S. citizen or resident alien. Note: If you have been notified by the IRS that you are currently subject to backup withholding, please tell this to the credit union when your application is being processed.

B: Account Agreement: I/we certify the above information to be true and complete. I/we hereby apply for membership in the Discovery Federal Credit Union, and agree to conform to its bylaws and amendments thereof, copies of which have been made available to me/us, and subscribe for at least one (1) share. I/we authorize any person, association, firm, and corporation or personnel office to furnish information concerning me/us or my/our affairs upon request of Discovery Federal Credit Union. Further, I/we have read all account and membership disclosures and information and acknowledge receipt of a copy of all agreements and disclosures applicable to the accounts and services requested. The IRS does not require consent to any provisions of this document other than the certification required to avoid backup withholding.

Joint Account Agreement. By submitting this enrollment application and providing the requested information for a Joint account, Discovery FCU is hereby authorized to recognize any of the signatures subscribed hereto in the payment of funds or the transaction of any business for this account. The joint owners of this account hereby agree with each other and with Discovery FCU that all sums now paid in on shares, or heretofore or hereafter paid in shares by any or all said joint owners to their credit as such owners with all accumulations thereon, are and shall be owned by them jointly, with right of survivorship and be subject to the withdrawal or receipt of any of them, and payment to any of them or the survivor or survivors shall be valid and discharge Discovery FCU from any liability for such payment. The joint owners also agree to the terms and conditions of the account as established by the credit union. Any or all said joint owners may pledge all or any part of the shares in this account as collateral security to a loan or loans from this credit union. The right or authority of the credit union under this agreement shall be changed or terminated by said owners, or any of them except by written notice to Discovery FCU which shall not affect transactions theretofore made.

Checking Disclosure and Commitment. By submitting this enrollment application and providing the requested information for a checking account, I/we hereby request the Discovery FCU to establish the requested checking account for me/us, and all joint owners of this account, and agree to be bound by the bylaws, rules, and regulations of Discovery FCU.

E-Service Disclosure and Commitment. By submitting this enrollment application, I/we understand that a copy of the full Discovery FCU Electronic Services Agreement and Disclosure and the Discovery Online Services Agreement and Disclosure are available by calling or visiting the credit union office and that I/we may obtain a copy at no cost without obligation to apply for Electronic Access Services at any time. I/we agree to abide by the terms and conditions of the Electronic Services Agreement and Disclosure and the Online Services Agreement and Disclosure. I/we also acknowledge receipt of the disclosure statement informing me/us of my/our rights under the Electronic Funds Transfer Act and the Truth-in-Savings Acts, as applicable. I/we understand DFCU may terminate this agreement at any time. By completing this application, I/we agree to read the Electronic Services Agreement and Disclosure and the Online Services Agreement and Disclosure and agree to abide by the terms and conditions of the agreements.

E-Statement Disclosure and Commitment. By submitting this enrollment application and agreeing to accept e-Statements, I/we acknowledge that I/we will receive an e-mail each time my/our statement is processed indicating that my/our e-Statement is ready for viewing on Discovery FCU’s secure server. An e-Statement is in lieu of a paper statement. I/We also agree to receive notifications, disclosures, newsletters and account updates electronically.


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2744 Century Blvd., Wyomissing, PA 19610|tel 610.372.8010|fax 610.372.8105|ABA Routing #231385646
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