ATHENA CREDIT UNION

Athena@home ONLINE BANKING
AUTHORIZATION REQUEST FORM

YOU MUST BE A CURRENT MEMBER OF ATHENA CREDIT UNION IN ORDER TO USE Athena@home ONLINE BANKING AND
E-STATEMENT SERVICE. PLEASE PROVIDE ALL REQUESTED INFORMATION. WHEN YOU HAVE COMPLETED THIS FORM, PLEASE PRINT, SIGN AND MAIL TO:

Athena Credit Union
1427 W. First Street
Springfield, OH 45504

A PIN (PERSONAL IDENTIFICATION NUMBER) WILL BE MAILED TO YOU. YOU MAY CHANGE YOUR PIN AT YOUR CONVENIENCE ONCE YOU HAVE LOGGED ON TO Athena@home ONLINE BANKING.

APPLICANT/ACCOUNT OWNER

FIRST NAME: MI: LAST NAME:
E-MAIL ADDRESS: PHONE NUMBER:

 

JOINT APPLICANT/OWNER

 

FIRST NAME: MI: LAST NAME:
E-MAIL ADDRESS: PHONE NUMBER:

 

X______________________________________
APPLICLANT SIGNATURE		 X______________________________________
JOINT APPLICANT SIGNATURE

BY SIGNING ABOVE, I AGREE TO THE TERMS AND CONDITIONS GOVERNING THE SERVICES AS OUTLINED IN ATHENA CREDIT UNION’S Athena@home ONLINE BANKING SERVICE AGREEMENT, TERMS OF USE, TRUTH IN SAVINGS DISCLOSURE AND PRIVACY STATEMENT.

PLEASE PRINT AND SIGN THIS FORM. MAIL COMPLETED FORM TO:

Athena Credit Union
1427 W. First Street
Springfield, OH 45504

OR

STOP BY OUR OFFICE FOR YOUR REQUEST TO BE PROCESSED