PROFESSIONAL AFFILIATION APPLICATION
SECTION l - Personal Information
BUSINESSS ADDRESS
CUSTOM JAVASCRIPT / HTML
Shipping Address (if different from your business address, not a PO Box)
SECTION II - Professional Information
Please Circle All Designations/Certifications/Licenses That Apply To You
CUSTOM JAVASCRIPT / HTML
ATTORNEYS ONLY
Please Mark All That Apply To You
CUSTOM JAVASCRIPT / HTML
1. How did you hear about us?
2. Have you ever had any disciplinary or legal action, past, current or pending, by any State Agency taken against you or your firm? If yes, please explain below.
SECTION III - Professional Affiliation Set-up
Application processing and setup: $695 (one-time)
Upon approval you will receive the following items to get you started:
- Live or Online Basic Training Institute - (Tuition waived during your first year)
- Personal Estate Preservation binder for your state (Sample Doe Trust)
- The Living Trust book by Henry Abts, III
- Personal Estate Preservation Client Workbook
- Sample client information brochures
- Quick-Start Training Program
If you wish to explore other options, click HERE to set up an appointment to discuss, OR call our Advisor Services line at: (800) 292-0223 Ext. 102
METHOD OF PAYMENT
1. Credit Card online (VISA,MASTERCARDorAMERICANEXPRESS)
2. I will pay by check: Please make payable to the Estate Planning Source and mail to 5301 Longley Lane, Suite D-150, Reno, NV 89511
PLEASE INCLUDE THE FOLLOWING WITH YOUR APPLICATION:
1. A copy of our business card
2. 3 business references (Who have known you for 3 or more years.)
3. Any pertinent printed information regarding you and/or your company i.e. articles, brochures, etc.
I certify that the above information contained in this application and any attachments I submit are true and correct.