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Membership Application - Community Bankers of Iowa

 
   
Bank Information (to be displayed online)
Bank Name *
Street Address *
Mailing Address
City *
State *
Zip Code *
County *
Telephone Number *
Fax
Website
Email *
Principal Contacts
Contact 1
First Name *
Middle Initial
Last Name *
Complete Title *
Preferred recipient of CBI Newsletter and correspondence *

Contact 2
First Name *
Middle Initial
Last Name *
Complete Title *
Preferred recipient of CBI Newsletter and correspondence *
Branch Locations
Please list information for All Branches
Branch 1
Branch Name *
Street Address *
Mailing Address
City *
State *
Zip Code *
County *
Telephone *
Fax
Email *
Contact Name *
Contact Title *

Billing Address (if different)
Street
City
State
Zip
Additional Information
For access to free CBI supported peer groups and other professional enrichment, please include name & email addresses for personnel responsible for the following areas:

Operations
Name
Email

HR
Name
Email

Marketing
Name
Email

IT Officer
Name
Email

Sr. Lender
Name
Email

Ag. Lender
Name
Email

Compliance
Name
Email

Cashier
Name
Email
Membership Investment
Membership Type: *
Primary Directory Category *
Additional Directory Categories
  • Primary Directory listing is complimentary
  • Up to two additional Directory listings are complimentary
  • After two, additional Directory listings are $35 each
**Hold CTRL on your keyboard to select multiple categories**
Number of Full Time Employees:  
Number of Part Time Employees:  
Number of Rooms (Accommodations):  
Number of Seats (Restaurants):  
Number of Associates (Realtors, Attorneys):  
Number of Locations ($35/add. location):  
Millions in Assets (Financial Institutions):  
Enhanced Membership ($50):
   
$ 
$ 
$ 
Total: $ 

The contents of this box are for testing purposes. This box will be removed when the form goes live.
Full-Time Employees
Part-Time Employees
Hotel/Motel Rooms
Restaurant Seats
Additional Associates
Additional Associates Cost
Additional Locations
Additional Locations Cost
Assets
Assets Cost
AdditionalCategories
Additional Categories Cost
NumberOfAdditionalCategories
additionalItem1Cost
Annual Dues (charged to card)
Tax (charged to card)
Fee (charged to card)
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*
NOTE: If selecting to pay by Check, please do not fill out the Credit Card Information section at the bottom of the form. Thanks.
   
Agreement
I understand that by confirming and providing the information above, I consent for my bank and branches to receive correspondence regarding membership benefits and services sent by or on behalf of CBI and its subsidiaries.
Please click submit only one time.  The transaction may take several seconds.




Community Bankers of Iowa | West Des Moines, IA