Personal Banking Questionnaire


Notice: E-mail is not a completely secure channel of communication. We ask that you limit your use of the e-mail form below to request general information about our customer services and products or general feedback about our website. We strongly suggest that you do not e-mail sensitive account information such as your Inland Bank Debit card number(s) or other account number(s), Social Security number, PIN, mother’s maiden name, or passwords.


Please answer the following questions when considering your preferences for a checking account.

 1. What features interest you?




 6. What type of services do you currently use or would like to know more about?

Loyalty Rewards Program Debit Card Access Protection (CAP)

I would switch to Inland Bank if you set up my bill payees for me. Yes No

 9. What can we do to make your banking experience a 10?


By providing contact information, you can expect a call from an Inland Bank personal banker by end of next business day.



How would you like to be contacted?

Contact Number Email Address:

Your Preference for a return call time (a.m./p.m.):

What Branch is most convenient?



Please Note: Do not include any confidential information on this form.