Member Application Form

To apply, print and complete this form and fax to:
301.907.2864, ATTN: Membership Department

Or, mail to:
AFP
P.O. Box 64714
Baltimore, MD 21264

  
 

For AFP Use Only
CT14 ____________
Date ____________
CS Dept _________

  
 
 

Please TYPE or PRINT.

Name: ____________________________________________________________

Address: __________________________________________________________

City, State, Zip Code: ________________________________________________

Phone: _________________________   Fax: ___________________________

E-mail: ____________________________________________________________

Membership ID#:  _______________

Name of most recent employer: ________________________________________

Last date of employment: ____________________________

*NOTE:

I affirm that all the information I have stated is true. I understand that membership is conditional upon the qualifications outlined by the Career Trust program. I understand that the information I have listed above is subject to verification by AFP. If I become re-employed within the calendar year of my dues suspension I agree to remit dues to AFP for the membership year.



Signature: __________________________________ Date: _______________

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