GPO Online Visa Application
Please provide the following information to complete your GPO Visa Application and then click the submit button at the bottom of the page.  You will then be contacted by a member service representative to complete the application process.
It's quick and easy, apply today!

Visa Limit Requested: 

Personal Information

First Name:    

Middle Initial:    

Last Name:    

Suffix (Jr., Sr., etc.):   

Birthdate:

Home Phone Number:    

Work Phone Number:    

Street Address:    
 

City:     

State:     

Zip Code & Extension:    

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E-Mail Address:
 
Employer:
Position:
Length Of Employment:
Net Monthly Income:

Balance Transfer Information
Card #1 Type:
Creditor Name:
Balance Amount: $
   
Card #2 Type:
Creditor Name:
Balance Amount: $
   
Card #3 Type:
Creditor Name:
Balance Amount: $
*Select the Branch you would like to follow up your loan application with:
New Hartford Office Utica Office
Oneida Office Ilion Office
St. Luke's Office Dolgeville Office
   
I (we) also authorize the credit union to verify or obtain information concerning my(our) credit standing, including initial and subsequent consumer reports. I may ask for the names and addresses of credit agencies contacted.