Union Members Union Membership Application

Please complete ALL required fields to submit your PRIMARY member application to access your Vacation Funds.

Fields with an asterisk (*) are required.

If you would prefer to complete a PDF, you can download the Union Membership Form and open it in Adobe Reader to fill in the fields and print it out (download the PDF to your computer first.)


Please read and initial that you acknowledge access to required disclosures via electronic delivery:

  • Qualstar will provide all account disclosures electronically after the account is opened.
  • Access to these disclosures is provided via website links (PDF copies can be downloaded), and your access is confirmed by your completion of this application which is also provided electronically.
  • You can request paper copies by calling 1-800-848-0018 or send a secure message via Mobile or Home Banking once registered for access.
Jr., Sr., II III, etc.
Physical Address
Mailing Address
Please upload an image of your State ID (jpg, png, or pdf only) - 30MB size limit. IMPORTANT: If the image uploaded is not your State ID, your application will not be processed.
One file only.
30 MB limit.
Allowed types: jpg, jpeg, png, pdf.
(Please choose carefully; this will be required when you call or come to a branch.)
If you forget your word, we will provide this hint to remind you; e.g. if your word is "Evergreen" a hint could be "WA state tree."
Note: You can elect to add a Payable on Death (POD) Beneficiary if there is no Joint Member designated on the account. Does not apply to IRA accounts.
Please indicate other products/services you are interested in, and we will contact you with more information
Please certify for your tax status. Backup Withholding and Taxpayer Identification Certification. By signing below (my electronic signature), I certify, under penalties of perjury, that (1) am a U.S. person (including a U.S. resident alien), (2) the Social Security number (SSN)/taxpayer identification number (TIN) shown above is my/the correct identification number and (3) I am NOT, unless designated below, subject to backup withholding because I have not been notified that I am subject to backup withholding as a result of a failure to report all dividends or interest, or because the IRS has notified me that I am no longer subject to backup withholding (indicate any that apply.)
Tax Status
These options are not common, if you are not sure of your status please contact us.
By initialing below (my electronic signature), I/we agree to the terms and conditions of the Membership and Account Agreement, Truth-in-Savings Rate and Fee Schedule, Funds Availability Policy Disclosure (all available online at https://www.qualstarcu.com/new-account-disclosures), if applicable, and to any amendment the credit union makes from time to time which are incorporated herein. I/we acknowledge I am able to access the Account Agreement and Disclosure(s) available online (https://www.qualstarcu.com/new-account-disclosures), applicable to the accounts and services requested herein. If an ATM card or EFT service is requested and provided, I/we agree to the terms of and acknowledge receipt of the Electronic Funds Transfer Agreement. I/We authorize Qualstar to check my/our credit, verify employment history, obtain a credit report, and to answer questions about its credit experience with me/us. I further acknowledge that any unclaimed funds in my account may be escheated to the State of Washington as per escheatment laws, or may be returned to my union vacation trust, depending on my union trust agreement. The Internal Revenue Service does not require your consent to any provision of this Account Card other than the certifications required to avoid backup withholding. Type Initials Below:
By initialing below (my electronic signature) , I am also consenting to allow Qualstar Credit Union and any related service providers to contact me at any telephone number I provide now or in the future, in order to administer and service my account. These numbers may include, but are not limited to, mobile/cellular devices. These contacts may be made as a direct dial call or through the use of text messages, pre-recorded or simulated voice messages, and/or the use of an “automated telephone dialing system.” I understand and agree this is intended to be an ongoing authorization, effective as of the date signed, and will remain in effect until I provide notice of my revocation to Qualstar Credit Union. My acceptance below also allows Qualstar Credit Union to use the credit report pulled for the purpose of this request for any current or future loan approvals and consideration of offering me additional credit and/or services. I understand and agree this is intended to be an ongoing authorization for this and all future credit reports, effective as of the date signed, and will remain in effect until I provide written notice of my revocation to Qualstar Credit Union. Type Initials Below:

Be sure to click the “Submit” button to send us the primary application – after that you should see a pop-up message that confirms your application has been successfully received. Any incomplete fields will be highlighted – you will need to complete and then click “Submit.”

After receiving the success message for submitting the primary application, you can add a joint member/account owner (please do not submit a joint application without the primary submitted first.)