Hershey Federal Credit Union logo

LOAN APPLICATION
Please provide all the requested information. When you have completed the form, use the Submit button at the bottom to securely forward it to us.

Non-Members applying for loans with Hershey FCU will need to qualify for membership. Please indicate below how you are eligible for membership:

Eligibility:

You and/or your immediate family members who live, work, worship or attend school in Dauphin or Lebanon Counties can become members. Also, any immediate family member of current HFCU members are eligible to join. Immediate family members include spouse, children, siblings, parents, grandparents, grandchildren, step-parents, step-children, step-siblings, and adopted relationships.

Before proceeding, please confirm your eligibility below:
  • I live in Dauphin or Lebanon County
  • I work in Dauphin or Lebanon County
  • I worship in Dauphin or Lebanon County
  • I attend school in Dauphin or Lebanon County
  • I am an immediate family member of an existing member

By checking this box, I confirm I am eligible for membership as indicated above and understand that I would need to become a member if the loan I am applying for is approved.
Loan Information
Will there be a co-applicant on this loan application? 
Yes or No 
Amount requested 
Loan Type          
Length of Loan months
Personal Information
First Name:
Middle Initial:
Last Name:
Social Security Number: - -
Marital Status: Married
Unmarried
(includes single, widowed and divorced)
Birthdate (xx/xx/xxxx)
Home Address:
   City:
   State:
   Zip:
How Long? months
If you've lived at your current address less than 24 months, please provide your previous home address:
Previous Home Address:
   City:
   State:
   Zip:
Email Address:
Home Phone Number: () -
Employment Information
Length Of Employment: months
Work Phone Number: () -
Occupation:
Employer name:
Note: Enter N/A if not applicable
    Address:
    City:
    State:
    Zip:
Income & Asset Information
Gross monthly pay:
Other income Note: Alimony, child support or separate maintenance income need not be revealed if you do not wish to have it considered as a basis for repaying this obligation.
Debt Information
  Balance Monthly Payment
Rent or Mortgage
Any comments or questions you may have for us?

By submitting this application, I/We certify that this information has been supplied truthfully, accurately and voluntarily, and therefore authorize Hershey Federal Credit Union. to investigate our creditworthiness, credit history and financial responsibility through any credit bureau or by any other reasonable means for consideration for the loan applied for, or for any other services offered.  This application does not constitute a contract for the extension of credit.  

Thank You.  Upon receipt of this application, someone at Hershey Federal Credit Union will review your information and get back to you to extend credit, with additional questions or to request  further information. We appreciate this opportunity to be your financial partner.
Statement of Intent for Option Debt Protection Coverage

Life Plus Protection
Disability Protection
Involuntary Unemployment Protection

Check the coverage(s) desired. The credit union will disclose the cost of the voluntary debt protection to you. A separate Protection election which discloses the terms and conditions must be signed for coverage to become effective.

Please check if you are NOT applying this account or loan with your spouse. The credit being applied for, if granted, will be incurred in the interest of the marriage or family of the undersigned.
If this is a single application you may submit now!

 
Co-Applicant Information
First Name:
Middle Initial:
Last Name:
Social Security Number: - -
Marital Status: Married
Unmarried
(includes single, widowed and divorced)
Birthdate (xx/xx/xxxx)
Home Address:
   City:
   State:
   Zip:
How Long? months
If you've lived at your current address less than 24 months, please provide your previous home address:
Previous Home Address:
   City:
   State:
   Zip:
Email Address:
Home Phone Number: () -
Employment Information
Length Of Employment: months
Work Phone Number: () -
Occupation:
Employer name:
Note: Enter N/A if not applicable
    Address:
    City:
    State:
    Zip:
Income & Asset Information
Gross monthly pay:
Other income Note: Alimony, child support or separate maintenance income need not be revealed if you do not wish to have it considered as a basis for repaying this obligation.
Debt Information
  Balance Monthly Payment
Rent or Mortgage
Any comments or questions you may have for us?

By submitting this application, I/We certify that this information has been supplied truthfully, accurately and voluntarily, and therefore authorize Hershey Federal Credit Union. to investigate our creditworthiness, credit history and financial responsibility through any credit bureau or by any other reasonable means for consideration for the loan applied for, or for any other services offered.  This application does not constitute a contract for the extension of credit.  

Thank You.  Upon receipt of this application, someone at Hershey Federal Credit Union will review your information and get back to you to extend credit, with additional questions or to request  further information. We appreciate this opportunity to be your financial partner.

Please check if you are NOT applying this account or loan with your spouse. The credit being applied for, if granted, will be incurred in the interest of the marriage or family of the undersigned.