Required:
- Membership Application
- HSA Trust Application (must be completed in Google Chrome)
Optional:
- HSA Transfer Form - include if you are transferring an existing HSA account to Mid American
- Spouse/Dependent Authorization Form - include if you are adding an authorized signer
Printable applications can be submitted by:
- Fax 316-462-5771, attention Isabelle Jantz
- Mail to Mid American Credit Union, Attn: Isabelle Jantz, 8404 W. Kellogg Dr., Wichita, KS 67209
- For questions, contact Isabelle Jantz at 316-722-3921, ext. 272or by email at isabellej@midamerican.coop