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Order Checks

Use this form to order checks for your Glasford Bank checking account.

Please ensure all fields marked are filled in completely.

Customer Information

Accountholder Name *

Joint Accountholder Name

Phone Number *

E-mail address

Current Address Information

Has your address changed recently? *

Yes, my address has changed and/or will need to be updated on my new checks.

No, my address has not changed and is correct on my current checks.

Street Address *

Street Address 2

City, State *

Zip *

Account Information

Account Number *

Account Type

Check Information

Have you ordered checks for this account in the past? *

Yes, I would like to reorder with no changes.

Yes, but I have changes from my previous order.

No, I have never ordered checks for this account.

Starting Check Number *

Check Style *

If you choose 'other', an employee will contact you to complete your order after you click Submit at the bottom of this form.

Check Type *

Wallet

Duplicate

Other

Please note- there are additional fees for duplicates and specialty binding.

Press Submit only once, otherwise duplicate orders may be received.

CAPTCHA

This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.

Math question * 6 + 6 =

Solve this simple math problem and enter the result. E.g. for 1+3, enter 4.