Bank Inc.

Enrollment Form

Enter the appropriate information below. After you have filled in the necessary data, press the 'Proceed' button at the bottom of the page to continue to a page where you can verify your data.The 'Cancel' button will send you back to 'Login Page'. Internet Banking is FREE. The fee account applies to Statement and Check Reprints; both items have a $2.00 fee.

User ID can be up to 10 alphanumeric characters. Password must be 6-10 alphanumeric characters.

For more information about the fields on this page, click here.

Personal Information

First Name:

Last Name:

Address Line 1:

Address Line 2:



Zip Code:

Home Phone:

Work Phone: