Freedom Club Enrollment Form Question Title * Join the Freedom Club by choosing one of the following membership options: Maintain $500 balance in a Frontier Bank checking account and have a monthly automated clearing house (ACH) deposit Maintain $5,000 balance in any combination of Certificates of Deposit (CDs) Relationship with Frontier Bank Wealth Management & Trust Question Title * First Name Question Title * Last Name Question Title * Date of Birth (MM/DD/YYYY) Question Title * Street Address Question Title * City, State and Zip Code Question Title * Email Address Question Title * How did you hear about the Freedom Club? Website Social Media Frontier Bank Employee (Please list name below) Friend (Please list name below) Other (please specify) Question Title * If you were referred to the Freedom Club, please list the individual who referred you here. Would you like to enroll a spouse?A joint account covers both husband and wife. If one spouse is 50 or over, both individuals are eligible for membership. Question Title * Spouse's name, if applicable. Question Title * Spouse's date of birth Done
