* Denotes required fields

*Name (First and Last, Please)

*Street Address

*City    *County

*Zip

*Email

What is your age? Select a range Under 18 18-25 26-35 36-55 55+

*Do you belong to a credit union?
Yes
No
If yes, which one?
If yes, what types of accounts?
If no, why don't you belong?
If no, do you want to join?
Yes
No

*Did you know that credit unions are not-for-profit organizations?
Yes
No

*How did you learn about our Web site? (You may choose more then one answer)
Print advertising?
Radio advertising?
Transit advertising?
Billboard advertising?
In your credit union branch?
Other?
If other, then where did you learn about the Web site?

*Would you recommend credit union membership to friends or family?
Yes
No

What is your household income?
Select a range Under $25,000 $26,000 - $50,000 $51,000 - $75,000 $76,000 - $100,000 $100,000 or more

*Do you have an account at a bank?
Yes
No
If yes, which bank?
If yes, what types of accounts?
Savings
Checking
Business loan
Home loan
Other
Please specify "Other"

*Does your family belong to the same financial institution?
Yes
No

Check here if you want to be contacted regarding becoming a member of a Credit Union. Your responses are completely voluntary. We will not sell or disclose your personal information to anyone. Your responses (excluding personal information) may be used for promotional and/or marketing campaigns. You authorize us to use the information you provide for promotional and/or marketing campaigns, unless you opt out by checking the box below.

Check here if you do not want us to share your survey responses with credit unions or use your responses in promotional/marketing campaigns.