Get Started Leave me blank for Apply Now. Citizens Bank would like to hear from you. Let us know what type of account or service you are interested in, and someone from our staff will be in contact with you. New Customer? * Yes No Account Type * Personal Business Individual Joint I’m Interested In * Checking Accounts ID Secure Checking Reward Checking Gold Club Checking SmartStart Checking Business Checking Savings Accounts SaveUp Savings Christmas Club Kids Club Vacation Club Regular Passbook Savings Money Market Loans Agriculture Personal Construction Mortgage Freedom Line of Credit Services Online Banking Online Cash Management Telephone Banking Debit Cards Business Debit Cards Overdraft Privilege Merchant Capture Mobile App MyMobileMoney P2P Personal Info * Name * Last 4 of SSN * Date of Birth MM/DD/YYYY * Mother’s Maiden Name * Home Phone (xxx xxx xxxx) * Daytime Phone (xxx xxx xxxx) * Drivers License # * Issuing State * Choose a State Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District Of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Driver’s License Expiration Date (MM/YYYY) * Email Address * Address Residential Address * City * State * Choose a State Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District Of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Zip * Use residential address for mailing address Address City State Choose a State Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District Of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Zip Employment Current Employer # of Years Employed Debit Card Apply for a free Debit Card on this account? Yes No How did you hear about us? Newspaper Radio Email Search Engine Billboard Website Referred by Promo Code Other Comments Comments History * Have you had a transaction account at this or another financial intermediary within 12 months before making this application? Yes No Have you had a transaction account closed by a financial intermediary without your consent within 12 months before making this application? Yes No Have you been convicted of a criminal offense because of the use of a check or other similar item within 24-months of making this application? Yes No IMPORTANT Please read the following disclosures before accepting. I / We have read and agree to the terms and conditions shown above and agree to conform to the bylaws and any amendments of the bank. I certify that statements on this application are true and complete. By checking “I accept”, you acknowledge you have read and agree to the Account Agreement. I Accept Check if under 18. If so, parent or guardian required to sign as joint holder. Click here to view Account Agreement.Citizens Bank may need to contact you about your inquiry even if you don't finish it. By selecting "Submit", you agree that Citizens Bank of Lafayette may contact you at the phone number or email address you provide on this form. If you provide us with your mobile device information, you agree that we may contact you via your mobile device. (Your mobile carrier's charges may apply.) The "Get Started" form is an inquiry, not an application. Someone from our bank will contact you soon! * Required Field / Category Submit There was an error submitting the form Thank you for your submission!