NetTeller Enrollment Form

To provide you with NetTeller we need your personal information and signature. You can complete this form online, then print it out, sign it and then deliver to the following address:

Monarch Community Bank
Attention: NetTeller Enrollments
375 N. Willowbrook Rd.
Coldwater, MI 49036

Important SPAM / E-MAIL Notice:

Due to some e-mail programs automatic spam filtering settings, you may need to "allow" e-mail from the domain "monarchcb.com" in your settings. We will e-mail you a verification message that requires your response. Be sure to check all mail folders to ensure quick setup of your NetTeller account. Thank you!

I would like to sign up for Monarch Community Bank's FREE NetTeller program.

I would also like to sign up for Monarch Community Bank's FREE BillPay service.

I am a business owner/manager and would like information on Monarch's online Cash Management service to originate ACH items, wire transfers, tax payments, etc...

Business:

Name:

Address:

City:

State:

Zip:

SSN:

TIN (Business Customers Only):

Telephone:

(Home): (Work): (Cell):

E-Mail:

Signature:

Date:

Enter any additional information/comments below:

You may also fax this form to (517) 279-0222 or drop it off at any of our banking offices.

If you have questions regarding online banking please call (800) 882-2911 Once we have received your Enrollment Form and confirmation e-mail message, we will e-mail you with your NetTeller ID and Password.

Click here to return to our NetTeller page when finished.