Client Number:

Credit Union Name:

Your Name:

How many years have you worked in the credit union industry? 

What services do you offer at your credit union?

Provide a summary of the reasons you would like to join the CRC:

What can you offer Fidelity National Information Services and the Mercury product as a CRC member?

What positions have you held with financial institutions and what IT experience have you had?

What are the values which drive you in your career?

The CRC is a volunteer position.  How many hours per month will you be able to devote? 

Describe the direction (the long-term business plan) of your credit union.

Why did your credit union select Mercury?

Are you able to commit to attending Conference and our Annual CRC meeting in Salt Lake City each year?  [select] Yes No

Will your board support you?  [select] Yes No