CUNA Volunteer Certification Program Enrollment

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CUNA Volunteer Certification Program

CUNA Volunteer Certification Program Enrollment Form

Complete and submit the enrollment form online by filling in the field below.

If you would like to enroll via mail, mail a completed printed form to:

CUNA Volunteer Certification Program
PO Box 431
Madison, WI 53701-043

If you would like to enroll via fax, fax a completed printed form to 608-231-4253.

With questions or for more information, us or call 800-356-9655, ext. 4139.

PLEASE CHECK ONE

New enrollment - You’ll receive an invoice for the $100 enrollment fee (stock #28296-MWB)
Re-enrollment - You’ll receive an invoice for the $100 enrollment fee (stock #28297-MWB)

Fees are non-refundable and non-transferable.

Name:

Street Address:

City: State:

Zip:

Phone Number:

E-mail Address:

Credit Union:

CUID:

CU Street Address:

CU PO Box:

CU City: CU State:

CU Zip:

Present Volunteer Position:

CU Telephone:

CU E-mail:

How would you prefer to be contacted? (Choose one)
CU Address
Home Address

Are you an employee or volunteer of an affiliated credit union, a league that is a member of CUNA, U.S. Central or its member corporates, CUNA, or World Council of Credit Unions?
Yes
No
(Please note: Affiliation with CUNA/League is required for enrollment.)

CUNA Volunteer Certification Program Track (choose one):
Board of Director Track
Supervisory Committee Track

Have you taken any previous CUNA course credits (ex. VAP modules) which you would like transferred into this program?
Yes
No
(Only programs/courses, which include assessments (exams) and reported on your CUNA transcript, will be considered for this transfer. Credit transfers will be limited by CUNA Volunteer Certification Program requirements.)

No need to prepay. We’ll invoice your credit union for the $100 enrollment.
The enrollment fee does not include the value of the learning activities you choose

100% Guarantee
CUNA Center for Professional Development is committed to providing a quality learning experience with cutting-edge topics and expert instructors. If for some reason you are not fully satisfied, contact us and we’ll provide you a full tuition refund or credit.

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