New Member Application with Special Discount Step 1 of 714%Please scroll down to complete the application. If paying for Membership by check (which will delay your Membership until received and cleared), please make it out to: The Association of Divorce Financial Planners and mail it to: 2 Greenwich Office Park, Bldg 2 West, Suite 300, Greenwich, CT 06831. Otherwise please pay online via this form.HiddenBoth First and Last Names First Name(Required)Last Name(Required)Company NameEmail(Required)Most communications will be by email.Business Address Line 1Address Line 2CityStateZip Code / Postal CodeCountryI receive post at My Business Address Another Mailing AddressMailing Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRéunionSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Contact Phone(Required)FaxWebsite AddressLast Four Digits of Social Security #(Required)Last Four Digits of CFP Membership # (IF you have one)Membership dues are $225Please pay online with credit card or by check* (once you submit this form you will be taken to a page to make an online payment or get the address to mail your check to)Phone: 508-499-3700 EmailType of Membership Requested(Required) Member Associate MemberMembers: ADFP Members are divorce financial planning practitioners, i.e. use the divorce financial planning process. You must charge a reasonable fee-for-service and cannot be compensated in other ways for providing such services. Divorce financial planning cannot be offered as a free service in exchange for or with the hope of acquiring or being otherwise linked to a post-divorce money or investment management engagement or product sale directly or indirectly through other professional relationships. All Members are required to have errors and omissions insurance.Associate Members: Associate Members provide adjunct, specialized, supporting services to the divorce financial planning process. Examples include mental health professionals, business valuation experts, mortgage appraisers. The ADFP shall promote Associate Members as being distinct from Members. Associate Members’ names are not open to the public but accessible to Members for professional networking and referrals. You are allowed to participate on the ADFP Board and on committees. You can attend all educational events and the annual conference at the membership rate. You do not have voting privileges, even if serving on the Board.ADFP ActivitiesLast ADFP Webinar attended:Last ADFP Conference attended:Background InformationPrimary ProfessionDesignationsDesignationsSpecific to Divorce Financial Planning CDFA® FDS CFDS™ OtherOther Divorce Related Designations(Required)Please include the abbreviated as well as long name for the designation (e.g.: CPA - Certified Public Accountant)Financial DesignationsFinancial Designations CFP® CPA ChFC® CA (Chartered Accountant)Additional Financial Designations CMA (Certified Management Accountant) CGA (Certified General Accountant) Registered Investment AdvisorSECStateInvestment Advisor Representative Investment Advisor RepresentativeRIA(Required)Registered Representative Registered RepresentativeBroker Dealer(Required)Other Financial Designations Other Financial DesignationsDesignation / Monitoring Organization(Required)Other Designations JD PhD LCSW LPC MFT OtherAdditional "Other Designations"(Required)Please include the abbreviated as well as long name for the designation (e.g.: DMA - Doctor of Musical Arts)I have a professional interest in divorce financial planningPlease initial here.TrainingDo you have at least 3 years experience in Financial Planning?(Required) Yes NoHave you completed at least 5 divorce cases?(Required) Yes NoHave you completed at least 40 hours of mediation training?(Required) Yes NoHave you completed training in collaborative divorce?(Required) Yes NoADFP MISSION STATEMENTThe mission of the Association of Divorce Financial Planners is:To heighten awareness of the benefits of divorce financial planning so that it will become an integral part of the divorce processTo bring knowledgeable and trustworthy personal financial planners to this professionTo accomplish this mission, the Association of Divorce Financial Planners will:Provide for professional continuing education of our membersEstablish engagement standardsHold members to a strict Code of Ethics & Professional ResponsibilityPromote communication, networking and peer reviewMarket and promote services and expertise through the ADFP website, speaking opportunities to the public and divorce professionals, public relations and other appropriate meansI have read and am supportive of the ADFP Mission Statement presented above(Required)Please initial here.I have read and agree to abide by the professional protocols and standards established by the ADFP and currently published on the ADFP website as the Definitions of Divorce Financial Planning, the Divorce Financial Planning Process, and Divorce Financial Planning Services(Required) Yes NoI charge an hourly based fee or flat fee for my divorce financial planning services.(Required) Yes NoIf a registered representative with a broker-dealer, I can present a letter from my broker dealer stating approval for the outside business activity of providing services to and charging fees for divorce financial planning advice provided to individuals.(Required) Yes No I am not a registered representative with a broker-dealerIf applying as a full member, I carry professional liability insurance that covers my divorce financial planning activities with(Required) Yes No I am not applying as a full memberDisciplinary ActionsI am currently in good standing with all entities monitoring the above listed designations .(Required) Yes NoI have a clean record of business integrity and have never had any suspensions, revocations or disciplinary actions related to any license or professional designation.(Required) Yes NoI have not been convicted of or pled guilty or no contest in any court to a crime, had a judgement withheld or deferred, or currently charged with committing a crime.(Required) Yes No* Important: Please attach details of any and all past suspensions, revocations or disciplinary actions related to any license or professional designation. (click below to attach a file)Max. file size: 256 MB.ADFP ActivitiesI agree to notify the ADFP Board within two (2) weeks of any situation or event that could negatively impact my standing with any of the above referenced agencies or entities. (initial here)(Required)Please initial here.I agree to be actively involved in the ADFP. (initial here)(Required)Please initial here.The ADFP is an all volunteer organization. Please indicate ways you would like to help below: Annual Retreat Marketing and Public Relations (Website & Social Media & Resources) Membership and Development Continuing Education (Programs & Standards) Support & Development Groups Sponsorship Development Practice and Professional Standards / Governance OtherPlease specify below:(Required)DisclaimerAgreement by members to adhere to ADFP Practice and Professional Protocols is a requirement of membership but should not be construed as a basis for any legal liability of the ADFP to third parties. It is strictly a condition for membership. The ADFP does not perform divorce financial planning services or take responsibility for the divorce financial planning or other services offered by its individual members. Services provided by members are provided independently of the ADFP and are completely their responsibility. Implying otherwise is a serious offense and grounds for membership termination.Signature (hold your left mouse button down and sign as best as you can with your cursor)Date(Required) YYYY slash MM slash DD Thank you for submitting this application. We will process it as quickly as possible, and look forward to having you as a member!Payment Options(Required)By Credit CardBy Check (mail in)New Member Annual Dues Price: Total Credit CardCard Details Cardholder NameCAPTCHAΔ