Select Employee Group Application

Thank you for your interest in becoming a Financial Wellness Partner at Revity FCU! Please fill out our partner application form and our team will be in touch with you within 1 business day. Should you have any questions concerning this application, please email marketing@revityfcu.org .

Name of Company(Required)

Mailing Address(Required)

Street Address Address Line 2 City State ZIP Code

Office Phone(Required)

Contact Person(Required)

Contact Phone(Required)

Contact Email(Required)

Briefly describe the type of business(Required)

This Company is a(Required)

Date Company was formed(Required)

Current Number of Employees(Required)

Please list all Company Officers/Owners and their titles(Required)

Are you associated with another credit union as a Select Employee Group or Financial Wellness Partner?(Required)

If you answered Yes to the question above, which credit union(s)?

Name & Title(Required)

This field is for validation purposes and should be left unchanged.