Eastern Bank Online Enrollment Form To enroll for Eastern Bank Online you must have an Eastern Bank checking account. If you do not have an Eastern Bank personal checking account, you may apply online, visit any Eastern Bank branch location or call 1-800-EASTERN (1-800-327-8376). At this time, checking accounts can only be opened for individuals residing in the following New England states: Massachusetts, Connecticut, Rhode Island, Maine, New Hampshire and Vermont. Please read the Eastern Bank Online Agreement. This agreement contains important information about the terms of the service. You should read this Agreement carefully to understand how Eastern Bank Online works, as well as your rights and obligations if you register for and use this service. Information collected in this enrollment form will be kept confidential as outlined in Eastern Bank's Privacy Policy.

Below are the version years of Intuit Quicken^® and Microsoft^® Money supported by their manufacturers.
Please select the software you own or are planning to purchase.

Intuit Quicken®	2009      2008      2007
Microsoft® Money	Money Plus      2007      2006

Title	Mr. Mrs. Ms. Other
First Name
Middle Initial
Last Name
P.O. Box
Street Address
City
State	Select State Connecticut Maine Massachusetts New Hampshire Rhode Island Vermont
Zip Code
E-Mail Address
Home Phone	--
Social Security Number

The account noted below (the "Bank Account") will be designated as the Eastern Bank account from which the monthly Eastern Bank Online service fee will be deducted after your FREE 3-month introductory trial period expires.
Checking Account #

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List other Eastern Bank accounts (the "Additional Accounts") that you wish to view or use for sending/receiving funds transfers:

Checking Accounts:

Account #1

Account #2

Money Market Accounts:

Account #1

Account #2

Statement Savings Accounts:

Account #1

Account #2

Print and retain this form for your records.