Apply for a New Account

Thank you for your interest in opening an account with First Community National Bank! Please complete the below application and a FCNB Representative will contact you with further details. To complete the account opening process, you must visit one of our branches to sign a signature card and provide proof of identity.
What type of Checking or Savings 
Account would you like to open?  
What FCNB branch would you prefer to 
visit to complete your account application? 
Account Titling Information: : Individual
Joint
Primary Applicant Information
First Name: 
Middle Initial: 
Last Name: 
Physical Address: 
Mailing Address: 
City: 
State: 
Zip: 
Home Phone: 
Cell Phone: 
Email Address: 
Date of Birth: 
SSN: 
Driver's License State: 
Driver's License No.: 
Expiration Date: 
Employer: 
Type of Business: 
Occupation: 
Business Phone Number: 
Joint Applicant Information (if applicable)
First Name: 
Middle Initial: 
Last Name: 
Physical Address: 
Mailing Address: 
City: 
State: 
Zip: 
Home Phone: 
Cell Phone: 
Email Address: 
Date of Birth: 
SSN: 
Driver's License State: 
Driver's License No.: 
Expiration Date: 
Employer: 
Type of Business: 
Occupation: 
Business Phone Number: 
Comments: 
I have read and understood FCNB’s Privacy Policy and Important Information About My Account.
The information I have provided is correct to the best of my knowledge. I authorize this financial institution to check credit, account histories, banking references, and/or employment history should it be deemed necessary.