Personal On-Line Banking Application

I certify the information provided is true and correct. I authorize Campbell & Fetter Bank to verify any information included in this application prior to allowing access to my accounts.

I will read the On-Line Banking Agreement and hereby agree to be bound by the terms and conditions of this agreement prior to access of my accounts for the first time. The On-Line Banking Agreement is subject to change.

Name:	Name is required
Address:	Address is required
City, State Zip:	City, State Zip is required
Last 4 digits of SSN:	Last 4 digits of SSN is required Field not valid!
Phone:	Phone is required
Email:	Email is required You must enter an email address
Signature:	Signature is required