Please fill out the fields in the form to the right. One of our representatives will contact you within one business day to complete the process.

This form supports the maximum level of encryption technology your browser allows, up to 256-bit SSL encryption to protect your personal information while it is in transit. Please view our Privacy Policy for more information.

Coverdell Education Savings


  • Are you a new customer?
    Yes No

Personal Information:

Address Information:


  • Number of Joint Owners on this Account?
    0 1 2

Joint Applicant #1:

Joint Applicant #2:


Security Code

Please enter the letters and numbers from the image above.

  • The First National Bank of Dieterich reserves the right to use the above information to obtain verifications of identity and background before opening any accounts. We may also access information about you from a consumer reporting agency, such as a copy of your credit report, before opening any account. By submitting this form, I/we grant full permission to do so.

    This document is being secured using SSL encryption provided by your browser. Your information will be encrypted when using this form while in transit between your browser and The First National Bank of Dieterich.