Complete this section if your student enrolled in the Children's Savings Account program before January 2021

Student's first name *

Student's Last Name *

Parent First Name *

Parent Last Name *

Street Address *

Address Line 2

City *

State *

Zip Code *

Phone Number *

Email Address *

Phone Number *

Do you want your student to continue in the Children's Savings Account Program? *

Yes, I consent to converting my student's THA Children's Savings Account to a 529 GET Account and continuing with the program.

No. I do not want to continue with the THA children's savings account program and do not want to enroll in the 529 GET program. I understand that by exiting the CSA, Heritage Bank will mail me a check based on and including any deposits made to my student’s CSA account by myself, my family or my student. This also means that the check will not include any match deposits made by THA as well as any other incentives that were earned in the program over the years.