2007 Roster Form
Please print a copy of the completed form from your browser window as a confirmation for your records before you submit the form. After you successfully submit the form, a confirmation page will appear (this will not list your information). The League will provide a full confirmation of the information via e-mail within several days. Please contact the webmaster at oculmail@ohiocul.org with questions.
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Your name (person to contact if we have questions about the form)
 
Your phone number
 
Your e-mail (you will receive an e-mail confirmation within 5 business days)
 

Credit Union Information

Credit Union (Full Name)
 
Employer I.D.#
 
Street Address
 
Shipping Address (if different than above)

City

State

Zip
  
County
 
Telephone (with area code)
  
Fax (with area code)

Web Site Address (ex: www.OhioCreditUnions.org)


Credit Union Branch Locations
The League will not mail to branch locations or share this information with other parties. This is for the League's information only, and will be used to match CU branches with the appropriate legislative districts.
Branch 1 Street Address

City

State

Zip
  
Telephone (with area code)
  

Branch 2 Street Address

City

State

Zip
  
Telephone (with area code)
  

Credit Union Management Team

Name of CEO/Manager (with official title) 
 

E-mail address (ex. oculmail@ohiocul.org)

Telephone Extension


Name of Assistant Manager/VP (with official title) 

E-mail address (ex. oculmail@ohiocul.org)
 Telephone Extension


Name of Chief Financial Officer 

E-mail address (ex. oculmail@ohiocul.org)
 Telephone Extension


Name of Education Contact (with official title) 

E-mail address (ex. oculmail@ohiocul.org)
 Telephone Extension


Name of PR/Communications/Marketing Contact (with official title) 

E-mail address (ex. oculmail@ohiocul.org)
 Telephone Extension


Governmental Liaison - Public and Elected Officials (with official title) 

E-mail address (ex. oculmail@ohiocul.org)
 Telephone Extension


Outreach Services/Social Responsibility (with official title) 

E-mail address (ex. oculmail@ohiocul.org)
 Telephone Extension

 

CU Demographics Contact - Project Zipcode, CU Match Up (with official title) 

E-mail address (ex. oculmail@ohiocul.org)
 Telephone Extension

 

Community Activities Contact (with official title) 

E-mail address (ex. oculmail@ohiocul.org)
 Telephone Extension

Board of Directors Information

Name of Board President/Chief Elected Officer

Preferred Address (Include City, State, Zip)

Telephone (Include Area Code)

E-mail address (ex. oculmail@ohiocul.org)


Name of Board Vice President

Preferred Address (Include City, State, Zip)

Telephone (Include Area Code)

E-mail address (ex. oculmail@ohiocul.org)


Name of Board Secretary

Preferred Address (Include City, State, Zip)

Telephone (Include Area Code)

E-mail address (ex. oculmail@ohiocul.org)


Name of Board Treasurer

Preferred Address (Include City, State, Zip)

Telephone (Include Area Code)

E-mail address (ex. oculmail@ohiocul.org)


Name of Director 1

Preferred Address (Include City, State, Zip)

Telephone (Include Area Code)

E-mail address (ex. oculmail@ohiocul.org)


Name of Director 2

Preferred Address (Include City, State, Zip)

Telephone (Include Area Code)

E-mail address (ex. oculmail@ohiocul.org)

Name of Director 3

Preferred Address (Include City, State, Zip)

Telephone (Include Area Code)

E-mail address (ex. oculmail@ohiocul.org)

Name of Director 4

Preferred Address (Include City, State, Zip)

Telephone (Include Area Code)

E-mail address (ex. oculmail@ohiocul.org)

Name of Director 5

Preferred Address (Include City, State, Zip)

Telephone (Include Area Code)

E-mail address (ex. oculmail@ohiocul.org)

Credit Committee Information

Name of Credit Committee Chairperson

Preferred Address (Include City, State, Zip)

Telephone (Include Area Code)

E-mail address (ex. oculmail@ohiocul.org)

Name of Credit Committee Member 1

Preferred Address (Include City, State, Zip)

Telephone (Include Area Code)

E-mail address (ex. oculmail@ohiocul.org)

Name of Credit Committee Member 2

Preferred Address (Include City, State, Zip)

Telephone (Include Area Code)

E-mail address (ex. oculmail@ohiocul.org)

Name of Credit Committee Member 3

Preferred Address (Include City, State, Zip)

Telephone (Include Area Code)

E-mail address (ex. oculmail@ohiocul.org)

Name of Credit Committee Member 4

Preferred Address (Include City, State, Zip)

Telephone (Include Area Code)

E-mail address (ex. oculmail@ohiocul.org)

Name of Credit Committee Member 5

Preferred Address (Include City, State, Zip)

Telephone (Include Area Code)

E-mail address (ex. oculmail@ohiocul.org)

Supervisory/Audit Committee

Name of Supervisory/Audit Committee Chairperson

Preferred Address (Include City, State, Zip)

Telephone (Include Area Code)

E-mail address (ex. oculmail@ohiocul.org)

Name of Supervisory/Audit Committee Member 1

Preferred Address (Include City, State, Zip)

Telephone (Include Area Code)

E-mail address (ex. oculmail@ohiocul.org)

Name of Supervisory/Audit Committee Member 2

Preferred Address (Include City, State, Zip)

Telephone (Include Area Code)

E-mail address (ex. oculmail@ohiocul.org)

Name of Supervisory/Audit Committee Member 3

Preferred Address (Include City, State, Zip)

Telephone (Include Area Code)

E-mail address (ex. oculmail@ohiocul.org)

Name of Supervisory/Audit Committee Member 4

Preferred Address (Include City, State, Zip)

Telephone (Include Area Code)

E-mail address (ex. oculmail@ohiocul.org)

 We welcome your additional comments on any League service

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