Christmas Club Account Application
Your Personal Information
First Name:
Middle Initial:
Last Name:
Social Security Number:
Email Address:
Phone Number:
Current Address:
City:
State:
** Please Select **
Alaska
Alabama
Arkansas
Arizona
California
Colorado
Connecticut
District of Columbia
Delaware
Florida
Georgia
Hawaii
Iowa
Idaho
Illinois
Indiana
Kansas
Kentucky
Louisiana
Massachusetts
Maryland
Maine
Michigan
Minnesota
Missouri
Mississippi
Montana
North Carolina
North Dakota
Nebraska
New Hampshire
New Jersey
New Mexico
Nevada
New York
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Virginia
Vermont
Washington
Wisconsin
West Virginia
Wyoming
American Samoa
Federated States of Micronesia
Guam
Marshall Islands
Northern Mariana Islands
Palau
Puerto Rico
Virgin Islands
Zip Code:
Please deduct my 26 bi-weekly payments from my:
Checking
Savings
Account Number:
Bi-weekly payment amount to be deducted:
$10
$20
$40
Other
Other Amount
I wish to have my Christmas Club funds direct deposited into my:
Checking
Savings
Account Number:
I understand that a fee will be assessed and my Christmas Club account closed in the event that there are insufficient funds in my savings/checking account to cover the payment.
I have read the Truth and Savings Disclosure below.
Truth and Savings Disclosure
Submit