Christmas Club Account Application
Your Personal Information
First Name:     
Middle Initial:  
Last Name:     
Social Security Number:     
Email Address:     
Phone Number:     
Current Address:  
Zip Code:     
Please deduct my 26 bi-weekly payments from my:
Account Number:     
Bi-weekly payment amount to be deducted:

Other Amount  
I wish to have my Christmas Club funds direct deposited into my:
Account Number:     
    I understand that a fee will be assessed and my Christmas Club account closed in the event that there are insufficient funds in my savings/checking account to cover the payment.
    I have read the Truth and Savings Disclosure below.
Truth and Savings Disclosure