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Order Checks
* indicates a required field
*
Your Name:
*
Your Member Number:
Joint Owner:
*
Your Address:
*
City, State and Zip:
,
,
*
Phone Number:
Do you want your phone number printed on the checks? :
*
How many boxes of checks do you want?:
*
Shipping Options:
If selecting branch or other address, please add to Notes. We will only ship to an address that is already associated with your account. There is a $8.80 per box shipping and handling fee.
Home address
Dort Financial branch
Other address
Notes:
* indicates a required field