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Sign Up for Internet Banking

Please provide us with the information requested below.   After you fill out and submit this form, it will be emailed to the appropriate bank representative via SECURE email.  We will call you to confirm your request for an on-line account during normal business hours, often the same day.

* First Name: Mi:
* Last Name: 
*  Business Name (If Applicable):
* Home Phone:        
* Work Phone:        
* Social Security Number:        
* Email Address:
* Re-enter E-mail Address:
Account Numbers:
 (Please list the account numbers that you currently have. If your Checking Account and Savings Account currently appear on the same statement, both accounts must be listed)
*  1 4 7
  2  5  8
  3  6  9

By entering the confirmation code below, I certify that the information provided is true and correct. I authorize Elkhorn Valley Bank to verify the information on this enrollment form and allow access to all accounts listed above of which I am an owner. I further certify that I have read the Elkhorn Valley Bank Disclosure and I agree to the terms and conditions.

*Confirmation Code:   (To complete your internet banking enrollment, you must click on the Elkhorn Valley Bank Electronic Statement Disclosure button below to receive a confirmation code.)


To complete your enrollment for Internet Banking, you must click on the Elkhorn Valley Bank Internet Banking Agreement Link below to receive a confirmation code. Once you have the confirmation code, enter it in the field above in order to submit this application

Elkhorn Valley Bank Internet Banking Agreement

You will need Adobe Reader in order to view the Electronic Statement Disclosure. Adobe Reader is free software used for viewing and printing electronic forms. To download, click here or go to www.adobe.com and follow the online instructions.