New Student Application Renewal Student Application

Name (first, middle, last)

Firm Name (if applicable)

Street Address

City, State, ZIP

County

Office Phone
Home Phone (not for publication)

Fax

Email

Please check the following designations that apply to you:

PhD JD Esq. EdD MSW

CPA CFP CDFP Other (Specify)

Date (xx/xx/xxxx)

Student Membership Fee: $25.

Click "Submit" and you will be directed to a page where you can either a) pay online using Pay Pal (no pay Pal account needed) or b) opt to mail your check.

WE RECOMMEND YOU PRINT THIS PAGE BEFORE SUBMITTING TO PRINT A COPY OF YOUR COMPLETED APPLICATION. ONCE YOU HAVE CHECKED IT CAREFULLY FOR ACCURACY AND COMPLETENESS, PLEASE CERTIFY THE FOLLOWING. (You must check the following box before submitting the form:)

You must chedck this box before submitting. I have checked this form for accuracy and completeness and, if desired, I have printed the page for my records.

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