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Request Form

If you have any questions about our products and services, please complete this form and click "submit". Don't forget your contact information so we can get back to you. Fill out the form below. Please do not send confidential or sensitive information electronically.

* Indicates required fields

What would you like information about?
 Checking Accounts
 Savings Accounts
 Consumer Loans
 Home Financing
 Business Services
 Employment Opportunities
 Other
 
Comments, Questions or Suggestions
 
Please tell us about yourself
Are you currently a customer of Melrose Cooperative Bank?
Yes   No
 
If "Yes", what type of account do you currently hold?
Please choose all that apply.
 Personal Checking
 Personal Savings
 Business Checking
 Mortgage
 Consumer Loan
 Other
 
How would you prefer we get back to you?
The best time to reach you?
 
Please include information necessary for us to contact you.
 
Name*
Email*
Address*
 
City*
State*
Zip Code*
Phone*
Fax
Comments/Questions
 

Please note:
Time-sensitive requests should not be sent through our information request form. Please call (866)665-2500 to speak with a customer service representative.

Stop payment requests, wire transfer requests, lost ATM or MasterMoney™ card notifications, lost passbook notifications and ATM/debit card disputes WILL NOT BE ACCEPTED if sent via e-mail or this request form. Please call (866)665-2500 if you require assistance with these matters.