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    Apply for a Grant County Bank ATM or Visa Debit Card!

    In order to apply for a card for your account, please complete the form below. If your card has been lost or stolen, or if you have any questions about completing the application, please call our service center at (304) 257-4111. Please note - if the account requested is a joint account, both owners should complete this form.


  • Please choose a card type

    OK Please choose a card type is required


  • OK Account Number is required
  • Optional OK Business Name (if applicable) is required
  • OK First Name is required
  • Optional OK Middle Initial is required
  • OK Last Name is required
  • Optional OK Suffix is required
  • OK Address is required
  • OK City is required
  • OK State is required
  • OK Zip Code is required
  • Daytime Phone Number

    - -
    OK Daytime Phone Number is required
  • Home Phone Number

    - -
    Optional OK Home Phone Number is required
  • Social Security Number

    - -
    OK Social Security Number is required
  • Birth Date

    OK Birth Date is required
  • OK E-mail Address is required
  • OK Employer is required
  • How would you prefer to be contacted?

    OK How would you prefer to be contacted? is required
  • OK Other is required


    By clicking on the "I Accept" button below, I am applying for a Grant County Bank Visa Debit Card or ATM Card. I understand this is not a credit card and that the dollar amount of the purchases made with this card will be deducted from my Grant County Bank checking account listed above. I authorize Grant County Bank to verify the information provided above and to request a credit report or other consumer data information if necessary. The Grant County Bank Visa Debit Card is available for qualified customers only. Other requirements apply. I agree to be bound by the terms and conditions covered in the appropriate Discloser Statement and Cardholder Agreement. Check the "I Accept" button to indicate that you (the applicant) have read the agreement and accept its terms.

    OK I Accept is required
  • Debit Card Application
  • Overdrafts and Overdraft Fees
  • Terms and Conditions