Application Form

	GREENE COUNTY ESTATE PLANNING COUNCIL	MEMBER LOGIN
	MEMBER LOGIN

Fill in the information below to apply for Greene County Estate Planning Council membership.

Personal Information

First Name

Last Name

Business Name

Email Address

Website

Office Information

Business Address

Business City

Business State & Zipcode

Business Phone

Business Fax

Disciplines

Please indicate what discipline(s) you practice.

Disciplines

Associate Member (if none of the above apply) Attorney CPA Financial Planner (must have achieved either CFP®, ChFC®, CFA, CIMA®, PFS, MSFS, or CLU®) Trust Officer (must have achieved either CTFA, CFP®, CFA, CPA, or JD)

Applicant Questionnaire

Please provide a brief synopsis stating your education, educational degrees and professional designations earned and current employment.

Please state current memberships in professional associations as well as current and past offices held and service on committees in professional associations.

Please provide a brief (100 words or less) statement describing how you meet the requirement of “…currently and actively engaged in some aspect of estate planning in the Southwest Missouri area."

Who nominated you to be a part of Greene County Estate Planning Council?

(Signature of applicant, if printing)
Date: Saturday, February 22, 2025

Please contact coordinator.gcepc@gmail.com with questions about council membership.