Online Banking Enrollment

Customer Information

Use this form to request online banking access if your automatic enrollment process failed or for Business Online Banking access. An online banking specialist will contact you for identity verification and assign you with a temporary user name and password.

Name *

Email Address *

Business Name

Date of Birth +

Address *

City *

State *

Zip *

Phone *

Best Time to Contact: *

I agree to the terms of the Online Banking Agreement and Disclosure available on Washington Savings Bank's website at washingtonsavings.com. I certify the above information is true and complete as of this date.

Signature *

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