Membership - Additional Information


2023-2024 NEW MEMBER APPLICATION for Attorney, CPA, Credentialed Financial Professional, or Employee of Bank Trust Dept. or Trust Company)

New Member Information (Please print clearly – will be entered on the GEPC website)

First Name: ____________________ Middle Name: ___________________

Last Name: ______________________

Designation (s): ______________________ (CPA, CTFA, ChFC, etc.)

Business Name: _____________________

Address: _________________________________________________

Phone: ________________________ Fax: __________________________

Email: _________________________ Website: _______________________

Name You Want on Your Name Tag: _____________________________________

I hereby apply for membership. I qualify for membership as (check appropriate item):

a. ________An Attorney licensed to practice in North Carolina

b. ________A Certified Public Accountant licensed in North Carolina

c. ________A Credentialed Financial Professional (CLU, ChFC or CFP)

d. ________Employed in a Bank Trust Department or Trust Company ________________ _______________________________________________

Date Signature of Applicant Recommended by (must be signed by two GEPC members as indicated below):

__________ ________________________________________________

Date             Estate Planning Council Member of same professional classification

___________ ________________________________________________

Date              Estate Planning Council Member of different professional classification


The Annual Membership fee is $125.00. Please make your check payable to the Greensboro Estate Planning Council, Inc. Please mail this form with your check to: