Investment Consultation Request Form
Through Member Investment & Insurance Services (MIIS)

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*Name (First M. Last)
*City, State, Zip ,
*Daytime Phone
Evening Phone
Email Address
Are you a school employee?  
If yes, which district?
Are you an existing MIIS Client?  
If yes, who is your representative?
Best time to reach you:
Most convenient branch:
I would like information about:

Securities offered through LPL Financial, member FINRA/SIPC. Insurance products offered through LPL Financial or its Licensed affiliates. Educational Employees Credit Union and EECU Member Investment Services are not a registered broker-dealer and is not affiliated with LPL Financial.

The LPL Financial Registered Representatives associated with this site may only discuss and/or transact securities business with residents of the following states: WA, OR, CA, NV, AZ, UT, ID, MT, WY, NM, TX, OK, SD, MN, IA, MO, AR, HI, MS, TN, KY, OH, PN, CT, MD, NC, SC, GA, FL, VA

Not NCUA Insured

May Lose Value

No Credit Union Guarantee

Not A Credit Union Deposit

Not Insured by Any Federal Government Agency

Please enter any comments or questions below.

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