Online Banking Enrollment Form

You can enjoy the convenience of Online Banking or enroll additional accounts to your existing Online Banking account access. Simply complete the form below and click Submit.

We will review the application, verify your answers, and e-mail you with your Login ID and temporary password to access Online Banking. You will be prompted to change your password and setup security questions the first time you log into Online Banking. If you are only enrolling additional accounts, the accounts will be added within 2 business days. If you have any questions or experience any issues, please contact TruPoint Bank at 276-935-8161.

Note: Each account holder must complete a separate enrollment form to receive a unique Login ID and password to access Online Banking. This enrollment form is for retail accounts only. Business account holders must contact the bank for Online Banking access.

Customer Information: *

First Name:


Last Name:

Mailing Address:




Primary Phone:


Social Security Number:

Primary Account Number:

Primary Account Type:

Date or Amount of last Deposit or Date of Last Payment, if loan:

* The above customer information is necessary to verify identity.


Please check only one applicable box below:

New Online Banking Enrollment

Add\Change\Remove Account to\from Online Banking

Account Information:

Simply click the ADD ALL ACCOUNTS FULL ACCESS box below if you wish to add FULL access to ALL accounts in which you are an owner. If you wish to add specific accounts for a new Online Banking enrollment or add accounts to your existing Online Banking, please enter each individual account number below and select the access and account type for each entry. If you are requesting to remove accounts, please enter each account number below, select Remove Access for the access type, and select the account type.



Account Number:

 Access Type*:

Account Type:









* Definitions for Access Types:

  • Full Access - You will have the full access available on this account.
  • View & Deposit - You may view account information and transfer funds into this account.
  • View Only - You will be able to view balances and transactions.
  • Deposit Only - You will be able to transfer funds into this account from other accounts with Full Access. You will not be able to view balance or transaction information.
  • Remove Access You will be requesting to remove the account from Online Banking access. The account will no longer be available for access.

Please Note: You must be an account owner for each of the accounts.