New Accounts Form

To open your account please fill out this form and bring it with you, along with current identification

*all information on form of identification must be correct

What type of account are you interested in?	Checking	Savings
	CD	SD Box
If you are interested in a checking account, which one? (Checking account information is on the next 2 pages.)	Blue Checking	Basic Blue Checking
	Senior Checking	Family Blue Checking
	College Club
If you are interested in a saving account, which one?	Regular Savings	Money Market
	Super Now Checking
Will you be setting up any direct deposit?	Yes	No
What type of direct deposit?	Payroll	SSA
	SSI	Pension
How often will it occur?	Annually	Quarterly
	Monthly	Weekly
	Bi-Weekly	Other
Will you need a debit card?	Yes	No

 

Customer Name:
Driver’s License Number:		Issued:		Expired:
Physical Street Address:
City:	State:		Zip:
Taxpayer ID Number:		Date of Birth:
Current Employer:
Cell Phone Number:		Email Address:

 

Basic Blue Checking Account

Opening Deposit of $100.00 Required

No Minimum Balance

Online & Mobile Banking

e-Statements

Debit Card

**Account will be service charged $2.00 per month for paper statements. **

Blue Checking Account

Opening Deposit of $100.00 Required

No Minimum Balance

Complimentary Personalized Checks

Complimentary Cashier's Checks and Money Orders (Limit 3 per month)

Complimentary Online & Mobile Banking

Debit Card

Discount on Safe Deposit Box

IDProtect®1

Debit Advantage®2

Up to $10,000 Accidental Death & Dismemberment Insurance2

Cellular Telephone Protection2

Travel & Leisure Discounts (available online only)

$hopping Rewards™ (registration/activation required; available online only)

Health Discount Savings This is NOT insurance (registration/activation required)

Monthly Membership $6.00

Family Blue Checking Account

Opening Deposit of $100.00 Required

No Minimum Balance Required

Complimentary Personalized Checks

Complimentary Cashier's Checks and Money orders (Limit 3 per month)

Discount on Safe Deposit Box

Photocopy Service

IDProtect®1

Debit Advantage®2

Up to $20,000 Accidental Death & Dismemberment Insurance2

Cellular Telephone Protection2

Travel & Leisure Discounts (available online only)

$hopping Rewards™ (registration/activation required; available online only)

Health Discount Savings This is NOT insurance (registration/activation required)

Monthly Membership $8.00

Senior Checking Account

Opening Deposit of $100.00 Required

For those 55 or better

No Minimum Balance Required

Complimentary Personalized Checks

Complimentary Cashier's Checks and Money Orders (Limit 3 per month)

Discount on Safe Deposit Box

Up to $5,000 Accidental Death & Dismemberment Insurance2

Debit & Credit Card Registration (registration/activation required)

Travel & Leisure Discounts (available online only)

No Monthly Fee

Super Now Checking

Interest Bearing Account

$1000 Minimum Balance

Unlimited deposits/withdrawals