GEMC Federal Credit Union

WEB ACCOUNT ACCESS AND POWER LINE APPLICATION

Member Account Number

P.O. Box 450449
Atlanta, GA 31145-0449

I would like to sign up for:
	Free Web Account Access
	Featuring inquiry capabilities and transfers between credit union accounts
	Bill Pay
	Featuring all bill pay capabilities
	Power Line
	Telephone account access system
	All Services Listed
First Name		Social Security #
Last Name	MI	Date of Birth
Street Address		Home Phone
City		Work Phone
State	Zip	E-Mail Address
		Share Savings Account Number (Member Number)
Current Employer

YOUR INITIAL PIN WILL BE THE LAST 4 DIGITS OF YOUR HOME PHONE NUMBER. YOU WILL BE PROMPTED TO CHANGE IT THE FIRST TIME YOU USE PowerLineSM and Web Account Access.

* For cross account transfer capability please list the account(s) you'd like to access:
,
(You must be a joint owner on the account(s) listed.)

Please refer to the MEMBERSHIP AGREEMENT and RATES AND FEE SCHEDULE for complete account details and information.

Note: Please click on the Submit button only one time.
The credit union will respond to your e-mail within one business day.
Please do not use e-mail to request transactions to your account.