If you are a new customer, please call the bank to set up your initial check order
at 887-7811 or 888-887-2341

Please complete this form, print it, then mail it or deliver it to one of these
West Iowa Bank locations
All information is required for order processing.

Account # 
Starting Check # 
Home Telephone #
Work Telephone # 
150 Checks
150 Checks
300 Checks

Colors Available:
Burgundy Marble
Blue Marble
Green Marble
Tan Parchment
Blue Safety
Patriotic Flags


For the bank to process a re-order, please type name and address as printed on your re-order form or check.  Maximum of 5 lines.  If you wish to change any information or the style of your check, please contact our bank, either in person or by phone.

Your checks will be printed at the West Iowa Bank.  Your account will be debited for the total of the order and you may pick your checks up at the bank.  Additional fee may be charged for postage if order is mailed out.