The Santa Fe Estate Planning Council, Inc

APPLICATION FOR MEMBERSHIP IN SANTA FE ESTATE PLANNING COUNCIL, INC.

NAME OF FIRM, if applicable:

WORK ADDRESS:

WEBSITE ADDRESS (optional):

TELEPHONE #: FAX #:

E-MAIL ADDRESS:

CREDENTIALS, PROFESSIONAL DEGREES OR DESIGNATIONS (Check all that apply):

Trust Officer Attorney Chartered Financial Analyst Certified Financial Planner Chartered Life Underwriter Chartered Financial Consultant Certified Public Accountant Enrolled Agent with the IRS Member, Appraisal Institute Licensed Actuary Sr. Residential Appraiser Sr. Real Property Appraiser Registered Investment Advisor Series 7 Licensed Broker Certified Trust and Financial Advisor Certified Fund Raising Executive Senior-level nonprofit development director Accredited in Business Valuation or Accredited Senior Appraiser

NUMBER OF YEARS IN ESTATE PLANNING (minimum of three):

AREAS OF SPECIAL EXPERTISE ON WHICH APPLICANT WOULD BE WILLING TO PREPARE A PRESENTATION TO THE MEMBERSHIP:

REASON FOR JOINING:

REFERENCE (Name of Current SFEPC Member):

Please return this form to: Patrick Barry, Membership Chair Phone: (505) 982-4676 E-mail: [email protected]