Online Information Request Form
Please provide the following information and indicate which products or services you would like to know more about, and then submit this form. Thank you for your interest in West Branch Valley Federal Credit Union.


Please Complete the Entire Form

 Information About You:

 First Name:   Middle Initial

 Last Name:

 Address 1: 

 Address 2: 


 State:         Zip Code

 Telephone:  -

 Fax:           -


 Check the Services or Products for which you want 

 I want to apply for Membership

 Standard Checking Preferred Checking Senior Checking

 Savings Account Christmas Club   Vacation Club

 Share Certificate Personal Loan   Auto Loan

 Mortgage Loan Home Equity Loan Line of Credit

 Visa Debit Card Visa Credit Card Total Teller  

 WBVFCU @ Home     Bill Payer

  Add Your Comments


West Branch Valley Federal Credit Union
Phone: (570) 323-9407  |  Toll Free: (800) 326-9539  |  Fax: (570) 323-2154  |  email: