Online Banking Enrollment Form
 

Please allow up to one business day for your application to be processed.  You will receive an email with login instructions when your application has been approved.  For assistance please call us at (541) 928-4536 or (800) 950-4536. Thank You!

 
*Required Fields
 
Login Information
Member Number*:

Your Temporary Password must be between 6 and 15 characters and contain at least one special character, one upper case letter, one number and one lower case letter.
Temporary Password*:
 
Member Information
Please provide at least one email address and one phone number to receive your secure access code for your Online Banking login.

First Name*: Middle Initial: Last Name*:
Social Security #*:  
Address*:  
Address:
City*: State*: Zip Code*:
Home or Mobile Phone*: Work Phone:  
Mobile Phone:  
Email Address*:

 

Please answer one of the following Security Questions*:



Dollar amount of last deposit within any account under this membership (Within $100 of the actual amount):

Dollar Amount:

 

Date of last deposit within an account under this membership:

Deposit Date:

 

Account balance of any checking account under this membership (Within $50 of the available or actual balance):

Account Balance:

 

Your Account Verbal Password:

Password:

 

Loan payment amount for any loan under this membership excluding VISA Credit Cards (within $10 of the actual amount):

Payment Amount:

 

Date of next loan payment for any loan under this membership excluding VISA Credit Cards:

Loan Next Payment Due Date:

Additional Account Access Information

Please provide any additional Member Number(s) that you wish to access through Online Banking using the same login. All accounts must have the same ownership as the information provided in the Member Information section above.

Account Member Number(s):
 
Signature:

Please allow up to one business day for your application to be processed.  You will receive an email with login instructions when your application has been approved.  Thank you!

 

*Signature: *Date:
  (Type your full name)   (Today's Date)
       
Apple Android