Check Order Form

Please fill out the information below and we will gladly process your order. As with all check orders, your checking account will be automatically debited. Your checks will be ready for pickup at the branch of your choice within 3-5 business days. Questions or comments, feel free to contact us.

These checks are available to Bank of Galesville Checking account customers only.

When the form is completed, print a copy and mail or fax to us at:

Bank of Trempealeau, PO Box 94, Trempealeau, WI 54661
or
FAX #608-534-7408 Attn: Check Order

Personal Information
Name:
Joint Owner Name:
Address:
City:
State:
Zip:
E-mail:
Home Phone Number :
Checking Account Number:
Is this a New Order or a Reorder
Which style would you like: (Price includes tax)	Click here to see the check styles page
What font would you like:
How many boxes would you like?
Single checks or Duplicate checks
Would you like your phone number to appear on your checks? Yes No
If you would like your driver's license number on your checks, please provide that for us here:
What number would you like your checks to start (or continue at:(0-9000):
Do you have a logo or by-line on your checks? If so, please indicate this or any other information here.	At which branch will you be picking up your checks?

Copyright © 2008 Bank of Galesville. All Rights Reserved.
Questions or comments, please contact us

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Personal Information