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Primary Contact Person for the Service at Branch 1*
Primary Contact’s Phone Number*
Primary Contact’s Email*
Branch Fax #*
CU’s Hours of Operation for Branch 1*
Address Where Equipment Will Be Located at Branch 1*
Shipping Address for Branch 1(if different than address)

Primary Contact Person for the Service at Branch 2*
Primary Contact’s Phone Number*
Primary Contact’s Email*
Branch Fax #*
CU’s Hours of Operation for Branch 2*
Address Where Equipment Will Be Located at Branch 2*
Shipping Address for Branch 2 (if different than address)

Primary Contact Person for the Service at Branch 3*
Primary Contact’s Phone Number*
Primary Contact’s Email*
Branch Fax #*
CU’s Hours of Operation for Branch 3*
Address Where Equipment Will Be Located at Branch 3*
Shipping Address for Branch 3 (if different than address)

Primary Contact Person for the Service at Branch 4*
Primary Contact’s Phone Number*
Primary Contact’s Email*
Branch Fax #*
CU’s Hours of Operation for Branch 4*
Address Where Equipment Will Be Located at Branch 4*
Shipping Address for Branch 4 (if different than address)

Primary Contact Person for the Service at Branch 5*
Primary Contact’s Phone Number*
Primary Contact’s Email*
Branch Fax #*
CU’s Hours of Operation for Branch 5*
Address Where Equipment Will Be Located at Branch 5*
Shipping Address for Branch 5 (if different than address)

Primary Contact Person for the Service at Branch 6*
Primary Contact’s Phone Number*
Primary Contact’s Email*
Branch Fax #*
CU’s Hours of Operation for Branch 6*
Address Where Equipment Will Be Located at Branch 6*
Shipping Address for Branch 6 (if different than address)

Primary Contact Person for the Service at Branch 7*
Primary Contact’s Phone Number*
Primary Contact’s Email*
Branch Fax #*
CU’s Hours of Operation for Branch 7*
Address Where Equipment Will Be Located at Branch 7*
Shipping Address for Branch 7 (if different than address)

Primary Contact Person for the Service at Branch 8*
Primary Contact’s Phone Number*
Primary Contact’s Email*
Branch Fax #*
CU’s Hours of Operation for Branch 8*
Address Where Equipment Will Be Located at Branch 8*
Shipping Address for Branch 8 (if different than address)

Primary Contact Person for the Service at Branch 9*
Primary Contact’s Phone Number*
Primary Contact’s Email*
Branch Fax #*
CU’s Hours of Operation for Branch 9*
Address Where Equipment Will Be Located at Branch 9*
Shipping Address for Branch 9 (if different than address)

Primary Contact Person for the Service at Branch 10*
Primary Contact’s Phone Number*
Primary Contact’s Email*
Branch Fax #*
CU’s Hours of Operation for Branch 10*
Address Where Equipment Will Be Located at Branch 10*
Shipping Address for Branch 10 (if different than address)

II. Management Information

Senior Management	Position
*	*
*	*

Board Members	Position
*	*
*	*
*	*
*	*
*	*
*	*
*	*
*	*

III. Financial Information
Total Assets*
Capital to Asset Ratio*
Percentage of Portfolio Delinquent*
Operating Expense /Avg. Assets*
Return on Avg. Assets*
Loans/Shares*
Date of Information (mm/dd/yyyy)*

IV. Related Companies
List Related Companies/ CUSOs	Ownership Relation

V. Market Information

1. What percentage of your credit union's membership is foreign-born (estimate) ?*

2. Which of the following groups represent at least 10% of your community/field of membership? Check all that apply.*

Easten European
Latino
Asian
African
Other:

3. Which of the following nationalities are represented in your target market? Check all that apply.*

Mexicans	Puerto Ricans
Salvadorians	Peruvians
Guatemalans	Jamaicans
Hondurans	Filipinos
Nicaraguans	Indians
Ecuadorians	Samoans
Colombians	Kenyans
Venezuelans	Ghanaians
Bolivians	Other:

4. Does your CU provide any services other than remittances to any of these immigrant groups? If so, check all that apply.*

International calling cards
Check cashing
Savings
Credit builder loans
Other:
None

5. Does your CU provide any of the aforementioned services to undocumented individuals? If not, why? Please check all that apply.*

Yes
No, not interested
No, don't know how to serve
No, unaware that our CU could serve these individuals
No, regulatory agency doesn't permit it
Other

6. Will your credit union provide remittance services to non-members?*

Yes
No
If no, please explain why not:

7. Which of the following are your competitors in terms of international remittances?*

Check cashing outlet
Western Union
Money Gram
Other:

8. Does your CU have any relationships with local Latino leadership or any other immigrant group(s)?*

Yes
No

9. Has your CU identified any Latino or immigrant specific media outlets (e.g., radio, TV, newspapers, etc.) that could be used to reach your target market?*

Yes
No

VI. Marketing Information

1. How does your CU plan to target the potential market of Vigo users? Please check all that apply.*

	Provide marketing materials in target market's native language
	Publish articles or ads in local immigrant newspaper(s)
	Advertise on local TV viewed by target community
	Advertise on local radio station listened to by target community
	Distribute Vigo flyers to members/potential members via mail
	Distribute Vigo flyers to local target market community groups
	Run promotional campaigns (e.g. first 100 members/potential members to utilize the service send for free or at discounted rate)
	Advertise in local target market stores, gas stations, laundromats, etc.
	Hang signs outside CU in target markets language
	Hang signs in target market's community
	Partner with immigrant groups to help promote your remittance program
	Support immigrant clubs (i.e. Hispanic children's soccer league)
	Other:

2. Do you have policies and procedures in place to carry out the service?*

Yes
No
In process

3. Does your CU currently have any marketing in Spanish or any other language?*

Yes
No

4. Does your CU have bilingual tellers who speak the language of the target market?*

Yes
If so, How many are bilingual?
No

5. Is your remittance program part of your stragtegic goal for immigrant outreach?*

Yes
No

VII. Other

1. Does your CU procure services from your state league?*

Yes
No

2. How did you find out about IRnet?*

League

Conference

Publication

WOCCU's Website

Another Credit Union

Other:

3. What do you expect to gain from this new service? Check all that apply.*

Expand membership

Generate income

Reach new market

Social mission

Other:

Remittances

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