eValley Registration Form

This is a request for eValley service. Your service will be activated upon receipt of this request. A letter will be sent to the address listed for the primary member on the account, providing you with the password you will need to start using this convenient, free service.

First Name: __________________________________________

Mail To:
Last Name: __________________________________________ Roanoke Valley CU
Account Number: __________________________________________ Attn:  Member Service
Social Security Number: __________________________________________ P. O. Box 13045
Date of Birth: __________________________________________

Roanoke, VA  24030
Home Phone Number: __________________________________________
Work Phone Number: __________________________________________ Or Fax to:
E-mail Address: __________________________________________ (540) 982-3937
Signature: __________________________________________
Date: __________________________________________

For more information about eValley, call (540) 982-3931 or e-mail info@roanokevalleyfcu.org.