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Join Us Online Membership Form

Please complete all your details in the form below, and click submit when you have finished.

Application for Membership
* Required Fields
Applicants Name:  *
Address:  *
Tel (home):  *
Tel (mobile):  *
Tel (work): 
E-mail Address:  *
Date of Birth:  *
Occupation:  *
Employers Name:  *
Work Address: 
Type of Accommodation:  *
If living less than five years at present address, please state previous address:  *
Please state the names of any other Credit Unions of which you have been a member:  *
Consent to use disclosure/Data Protection Acts, 1988 and 2003 and Section 71 of the Credit union Act, 1997
I understand that under the Data Protection Acts, 1988 and 2003 (the ‘‘DPA’’), my consent may be required for the Credit Union to process personal data that it may have in its possession concerning me (including disclosure to third parties). I note that this personal data may include sensitive personal data, such as data about my health, within the meaning of the DPA, the processing of which requires my explicit consent.
I also understand that under Section 71 of the Credit Union Act, 1997, the Credit Union, subject to exceptions listed in the Section, shall not disclose or permit to be disclosed, without my consent, any information that concerns an account or transaction of mine with the Credit Union.
For the purpose of assessing my application for membership, assessing any loan applications which I may make to you and generally for administering and monitoring any accounts I have with the Credit Union, including any loan accounts I have from time to time with you:
1. I consent:
(i) to you seeking information concerning applications for loans and my credit history from the date of my original consent from any credit union and from any credit reference bureau or agency and for that purpose you may disclose any relevant information in any loan application which I may make to you or which you may have concerning me to any such credit union or any such credit reference bureau or agency;
(ii) to any Credit Union or any credit reference bureau or agency disclosing information to you concerning applications for loans and my credit history from the date of my original consent with any such Credit Union or otherwise;
(iii) to the processing of any information relating to me, either contained in this form or application, for the purpose of assessing applications and administering any accounts I maintain with the Credit Union.
2. From time to time, the Credit Union, or third parties selected by the Credit Union, may use your details to inform you of goods and/or services which may be of interest to you. The use of your details for marketing purposes will depend on the preferences that you express below:
Opt-In (marketing by email, text message and fax)
I consent to the Credit Union, or third parties selected by the Credit Union, informing me of goods or services that may be of interest to me by email, text message or fax:


Opt-Out (other forms of marketing)
Please tick the box opposite if you do not want the Credit Union, or third parties selected by the Credit Union to inform you by phone or letter of goods or services that may be of interest to you.:
Please note that you have the right to access personal data held about you by the Credit Union and to correct any inaccuracies in such data.
I hereby apply for membership of and agree to abide by the rules of the Credit Union and declare that the information given by me on this form is true and correct to the best of my knowledge and belif and that I am not, nor have been, a member of any credit union other than listed above.
Name:  *
Date: 
To be completed by Parents or Guardians (if applicable)
* Required Fields
In the event that the application for membership is in respect of a person who is unable to give receipts:
I / we hereby apply for membership in the name of the said: 
And I / we acknowledge that all shares / deposits arising from this membership now and hereafter shall be his / her sole property and all withdrawals shall be applied to his / her sole benefit.
Signed: Parent(s) / Guardian(s) / Other 
Date: 
Verify your application
* Required Fields
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Edenderry Branch
  • Tel:
  • Address:
  • 046 9731755
  • O'Connell Square, Edenderry, Co. Offaly
Coill Dubh Branch
  • Tel:
  • Address:
  • 045 860 554
  • Coill Dubh, Naas Co. Kildare

Clane Carbury Allenwood Prosperous Robertstown

Click here for all branches contact details and opening hours

Croí Laighean Credit Union Ltd is Regulated by the Central Bank of Ireland. Reg No. 163CU