Enrollment Form

Enrollment Form for Retail Clients

We’re excited to welcome you to PeoplesBank. Allow us to help make your banking and payment options easier and more flexible! If you would like to receive a VISA® Debit Card or sign up for our Telephone Banking service, please complete the form below with your information and submit your request. If an email address is supplied, you will receive an email from us notifying you of receipt of this application containing further instructions.

Your Information

First Name *

Middle Initial

Last Name *

Email address *

Telephone *

Cellular Phone

Street Address *

City *

State *

Postal Code *

Social Security Number *

Birth Date *

Enroll for Telephone Banking

If you would like to sign up for Telephone Banking, please select and enter your Electronic Access Number below.

Telephone Banking Electronic Access Number
Access number must be an all numeric 8 digit number

Please enter the account numbers you would like to access below or select Enable All Accounts.

Primary Account Number*

Account Numbers

Account Numbers

Account Numbers

Account Numbers

Account Numbers

Account Numbers

Account Numbers

Enroll for a VISA® Debit Card

If you would like to order a VISA® Debit Card for your personal accounts, please enter the account numbers below. Limit three accounts. Business accounts cannot be ordered from the website. Please call (717) 846-1970 to inquire about Business account services.

Primary Account Number *

Account Number

Account Number

BR#REP (For Bank Use Only)

Contact Us

Questions? Contact Us

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