Remote Deposit Capture Enrollment Form

Fill out the form below to Enroll in our Mobile Remote Deposit app.

Required Field = *



* First Name

Company / Entity

* Last Name

* Current Business Email Address

* Current Business Phone Number


* I would enroll for Mobile Remote Deposit.

Anything else we should know?


* Type the above number:



Physical Address


FC of Western Kansas, ACA
1190 South Range
Colby, KS 67701
Phone: 785-462-6714
Toll-free 800-657-6048
Fax: (785) 462-7152

Monday - Friday 8am to 5pm CST

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