Check Card Application

Applicant Name:
Current Address:
City:
State:
Zip:
Date of Birth:
Social Security Number:
Current Home Telephone:
E-mail:
Applicant Employed by:
Position:
Month/Year Started:
Current Work Telephone:
Bank of Bartlett
Checking Account number:
Please Read Before Submitting:

I understand that this is not a credit card application. I have answered the questions in this application fully and truthfully, and all information provided is correct. I understand that if approved, cards and agreements (if any) will be mailed to the address listed on my Bank of Bartlett Checking Account. I promise not to use my check card until I have received a copy of the agreement governing it's use and terms. I authorize Bank of Bartlett to obtain information to check my credit records and statements made in this application.