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Online Banking Enrollment Form
*Required Fields
Login Information
Create a Login ID between 6-25 characters. It may contain all letters or a combination of letters and numbers; it cannot contain spaces. Please create a Login ID that you can remember as you will use this Login ID once your account is activated.
Desired Login ID*:
Customer Information
Please provide at least one email address and one phone number to receive your secure access code for your Online Banking login. You will be required to set your password after entering your secure access code.
First Name*: Middle Initial: Last Name*:
Social Security/Tax ID #*:    
City*:   Zip Code*:
Home Phone*: Work Phone:  
Mobile Phone:  
Email Address*:  
Additional Services
If you would like rights to Bill Pay and/or External Account Transfers, please check the appropriate box(s). Fees may apply. Click here to refer to our current fee schedule.
Bill Pay External Account Transfers
Security Information
Please fill out this information section for security verification. If you are unable to verify any or all of the information required, please contact Customer Service at 651-290-8176.
Date of Birth*:  
Date of Last Deposit*:  
Amount of Last Deposit*:  
Account Number* Account Type
Please provide the Account Number(s) that you wish to access through Online Banking. All accounts must have the same ownership as the information provided in the Customer Information section above.
Signature and Disclaimers
This document is being secured with SSL encryption provided by your browser. Your information will be encrypted when using this form while in transit between your browser and Western Bank.
*Signature: *Date:
  (Type your full name)   (Today's Date)
We will process this enrollment form within one business day of you submitting this request. If the enrollment form is approved you will receive an email with instructions on how to access Online Banking. The email will be sent to the email provided above. Please remember the Login ID provided above as you will use this during login.
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