Please fill out this secure form to begin your 90-Day free trial. * field required Leave me blank for Benefits Plus Membership Enrollment. Branch Location* Please Select Baker City Clarkston College Place Elgin Enterprise Heppner Hermiston Joseph La Grande - Downtown La Grande - Valley Milton-Freewater Pendleton Walla Walla Wallowa Checking Account (last 4 digits):* This is the Community Bank personal checking account that your monthly fee will be deducted from. Customer Information: First Name (Primary)* Last Name (Primary)* First Name (Joint) Last Name (Joint) Phone Number* Address* City* State* Please Select AL AK AZ AR CA CO CT DE DC FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY Zip* Email Address* I accept the Benefits Plus® membership and understand my account will be debited each month in the amount of $5.99 following the 90 day free trial period. I also understand that I can opt out of the Program and membership fee at any time.* Initial for Electronic Signature* Submit There was an error submitting the form We will send you an email to confirm your enrollment and to let you know how to begin using your benefits. Thank you! We'll be in touch with you soon.