RENEWAL INFORMATION UPDATE Membership Active Associate Student Patron Category: (Check Appropriate Box) Section I: Student Member please print or type Full Name Date: Mailing Address: City: State: Zip: Contact Phone: E-Mail Address: School Attestation ______________________________________________ (student name) is currently enrolled in the legal assistant/paralegal program with _ name of institution). I further attest that said applicant is of professional and honest character. Date: Signature: Printed Name of Program Director or Instructor Section II: Active and Associate Members please print or type Full Name: Date: Employer Name: Office Address: City: State: Zip: Office Phone: Office E-Mail: Firm Size: Number of Attorneys: Number of Paralegals Home Address: City State: ZIP: Contact Phone: Home/Other E-Mail: Preferred Postal Mail Address - Please circle one or provide new info. Home/Other Office Preferred E-Mailing Address - Please circle one or provide new info. Home/Other Office Year started as a Specialty: paralegal: Credential: CP/CLA CFLA/FCP ACP FRP CBA Other University/College Degree: Attended: Major: Date Graduated: Other formal or special education/ training/credential: CFPA Member Since:
RENEWAL INFORMATION UPDATE Membership Category: (Check Appropriate Box) Active Associate Student Patron Section I: Student Member please print or type Full Name Date: Mailing Address: City: State: Zip: Contact Phone: E-Mail Address: School Attestation (student name) is currently enrolled in the legal assistant/paralegal program with _ name of institution). I further attest that said applicant is of professional and honest character. Date: Signature: Printed Name of Program Director or Instructor Section II: Active and Associate Members please print or type Full Name: Date: Employer Name: Office Address: City: State: Zip: Office Phone: Office E-Mail: Firm Size: Number of Attorneys: Number of Paralegals Home Address: City State: ZIP: Contact Phone: Home/Other E-Mail: Preferred Postal Mail Address - Please circle one or provide new info. Home/Other Office Preferred E-Mailing Address - Please circle one or provide new info. Home/Other Office Year started as a paralegal: Specialty: Credential: CP/CLA CFLA/FCP ACP FRP CBA Other University/College Attended: Degree: Major: Date Graduated: Other formal or special education/ training/credential: CFPA Member Since: ______________________________________________