STUDENT MASTERCARD APPLICATION 
 Visit uiccu.org for a complete list of card benefits. 

With a credit line of just $500, our Student MasterCard allows you to build  
credit without building a pile of debt. 

We intend to apply for joint credit: 

____________
Initials 

____________
Initials 

APPLICANT INFORMATION (Please print clearly.  All information is required.) 

Are you a citizen or permanent resident of the United States? 

 Yes 

  No

_____________________________________________ 
(as you wish it to appear on the card) 
Name 

____________________ 
Date of Birth 

____________________ 
Social Security # 

____________________ 
Mother’s Maiden Name 

_____________________________________________      ____________________ 
Street Address 

Phone Number 

____________________ 
Email Address 

____________________ 
UICCU Member Number 

_____________________________________________ 
City, State   

Zip 

____________________________________________ 
Name of college or university at which you are enrolled 

_____________________________________________ 
Employer  

____________________ 
How Long at Employer 

$__________ 
Hourly Wage 

_____________ 
  Hours per Week 

Name:____________________________Address:_____________________________________________Telephone Number___________________________________ 

REQUIRED:  Please list the information of the nearest relative not living with you. 

Name:____________________________Address:_____________________________________________Telephone Number___________________________________ 

REQUIRED:  Please list the information of a second relative not living with you. 

OTHER APPLICANT INFORMATION (if applicable) 

_____________________________________________ 
Name 

(no plastic will be issued unless requested) 

____________________ 
Date of Birth 

____________________ 
Social Security # 

____________________ 
Mother’s Maiden Name 

_____________________________________________      ____________________ 
Street Address 

How Long at Address 

 ____________________ 
Home Phone 

  ____________________ 
Email Address 

____________________________________________________________________ 
City 

State 

ZIP 

____________________ 
Cell Phone 

Do You   Own   Rent  
Payment $___________ 

_____________________________________________   ____________________ 
Employer  

How Long at Employer 

____________________ 
Work Phone 

$___________________ 
Gross Annual Income 

 
 
 
 
 
 
 
 
 
Interest Rate and Interest Charges 

Introductory Annual Percentage 
Rate (APR) for Purchases, 
Balance Transfers and Cash 
Advances 

APR for purchases, Balance 
Transfers and Cash Advances 

A fixed Introductory rate of 0%-8.9%* shall apply for the first six months.  Thereafter, the APR for all outstanding 
indebtedness and new balances relating to purchases, cash advances, and balance transfer transactions shall be at the rate 
listed below based on your creditworthiness; or, if you do not qualify for an introductory APR.
12.9 – 19.9%* 
Non- Variable Rate 

* Your APR is dependent on your Credit Worthiness

How to Avoid Paying Interest 
on Purchases 

Your due date is at least 25 days after the close of each billing cycle.  We will not charge you any interest on purchases if you pay your entire 
balance by the due date each month.  We will begin charging interest on cash advances and balance transfers on the transaction date. 

Minimum Finance Charge 

None 

For Credit Card Tips from the
Consumer Financial Protection 
Bureau 

To learn more about factors to consider when applying for or using a credit card, visit the website of the Consumer Financial 
Protection Bureau at www.consumerfinance.gov/learnmore. 

Annual Fee 

None 

Transaction Fees 
1.

Internal Balance Transfer Fees

2. External Balance Transfer Fees

3. Convenience Check Fees 
4. Cash Advance Fees 
5. Foreign Transaction Fees 

1. None 
2. None 
3. None 
4. Either $5, or 3% of the amount of each
cash advance, whichever is greater 
5. 1% of each foreign transaction in U.S. 

dollars

Penalty Fees 

1.

2.

3.

Late Payment Fee 

Over-the-Credit Limit Fee 

Returned Check Fee 

1.

2.

3.

Up to $15 

None 

Up to $25 

•

•

How We Will Calculate Your Interest:  We use a method called “average daily balance (including new purchases).”  See your cardholder agreement for more details. 
Payments:  The minimum monthly payment is 2% of the new balance, or $25.00, whichever is greater.  If the unpaid interest and fees on the account are greater than the 
minimum monthly payment, the minimum monthly payment will become that amount.  Any amount that is past due or prior minimum payments that were not made will also be 
added to the minimum monthly payment amount. 
Loss of Introductory APR: You will lose your Introductory APR if your account becomes delinquent or over the limit. 

•
• This information is accurate as of 03/15/2018.

Consensual Security Interest

You grant us a security interest in all individual and joint share and/or deposit accounts you have with us now and in the future to secure your credit card account. Shares and 
deposits in an IRA or any other account that would lose special  tax treatment under state or federal law if given as security are not subject to the security interest you have given in 
your shares and deposits. You may withdraw these other shares unless you are in default. When you are in default, you authorize us to apply the balance in these accounts to any 
amounts due. For example, if you have an unpaid credit card balance, you agree we may use funds in your account(s) to pay any or all of the unpaid balance.

By signing or otherwise authenticating below, you are affirmatively agreeing that you are aware that granting a security interest is a condition for the credit card and you intend to 
grant a security interest. You acknowledge and agree that your pledge does not apply during any periods when you are a covered borrower under Military Lending Act. For clarity, 
you will not be deemed a covered borrower, and your pledge will apply, if: (i) you become obligated on a credit transaction or establish an account for credit when you are not a 
covered borrower; or (ii) you cease to be a covered borrower.

SIGNATURE(S) 

1. You promise that everything you have stated in this application is correct to the best of your 
knowledge. If  there are any important changes you will  notify  us in writing immediately. You
authorize the UICCU to obtain credit reports in connection with this application for credit and
for  any  update,  increase,  renewal,  extension  or  collection  of  the  credit  received.  You
understand that the UICCU will rely on the information in this application and your credit report 
to make its decision. If you request, the UICCU will tell you the name and address of any credit 

bureau from which  it received a credit report on you. It  is a federal crime  to willfully and 
deliberately  provide  incomplete  or  incorrect  information  on  loan  applications  made  to 
federal credit unions or state chartered credit unions insured by the NCUA.  
2. You understand that the use of your card will constitute acknowledgement of receipt and 
agreement to the terms of the credit card agreement and disclosures. MasterCard may not 
be used for any illegal transactions. 

___________________ 
 Date 

 Applicant Signature 

 ____________________
 Date 

 Other Applicant Signature 

FOR UICCU USE ONLY Approval Checklist 

The member is currently enrolled at a 2 or 4 year college or university(vocational or technical schools do not qualify) 
2 references above and all information is complete 
Member has a checking account with the UICCU 
One of the following is complete if Student only on application (please indicate which item) 

 The member has no credit score  or  

 The member credit score exceeds 640 

Member has one of the following if Student and a co-applicant are on application (please indicate which item) 

  Co-Applicant credit score exceeds 640  or  

 Properly approved exception to score requirement obtained and noted in the loan underwriting system

Member has employment income and  D/I Ratio is <45% not including housing expenses or student loans (either as income or obligations)   
or Co-applicant present  and combined D/I Ratio is <45% 
Loan is complete, properly approved, and funded in the loan underwriting system 

Date_____________ 

 Approved 

Employee Number___________________________________ 

 Denied 

Employee Signature__________________________________