Star One Visa Debit Card Application
Please complete, print, sign, date, and mail this application to Star One Credit Union, P.O. Box 3643, Sunnyvale, CA, 94088-3643, Attn: Card Services. You may also fax this form to (408) 543-5203 Attn: Card Services.
If you would like an ATM Card only, please contact Member Phone Services at (408) 543-5202 or (866) 543-5202.
| First & Last Name | Member Number | ||
| Address | Daytime Phone | ( ) | |
| City | |||
| State | |||
| Zip |
Please send a free Star One Visa Debit Card for me, and/or A Star One Visa Debit Card for my joint owner.
By signing this application I/we agree that I/we have read and agree to be bound by the terms and conditions of the Visa Debit Card Agreement and Disclosure Statement. I/we understand that the Visa Debit Card Agreement and Disclosure Statement will be mailed with my/our cards(s).
Check here if you want a computer generated Personal Identification Number (PIN).
If you would like to select your own PIN, please enter your five digit PIN below (If you decide to select your PIN, please note that your PIN will be seen by a Star One employee who will enter it into our main computer system).
Use only numbers 0 through 9. Letters may not be used for your PIN.
Primary Member's PIN Joint Member's PIN
All account holders requesting a Visa Check Card must sign below.
| __________________________ | __________ | __________________________ | __________ | |
| Primary Member Signature |
Date |
Joint Member Signature (if joint member card is requested) |
Date |
