Term Deposit Enquiry

9 September, 2010

Please provide the following information and one of our Deposits Specialists will contact you and assist you through the application process. For more information, please call us on 1300 888 700. Required fields are marked with an asterisk (*).
* Are you an existing Laiki Bank Customer	Yes No
* Subscriber No.

* First Name
* Last Name
* Suburb
* Post Code
* Preferred Contact Time
* Phone
* e-mail address

* Please state how much you would like to deposit? (Minimum deposit required $1000):
$
* Please select the period you wish to make the deposit for:

* Where did you hear about this offer?

Comments:

Thank you

	SUBMIT CANCEL