MEMBERSHIP APPLICATION
ALL FIELDS MUST BE COMPLETED INORDER TO BE INCLUDED IN OUR
DATABASE TO INSURE YOU RECEIVE OUR E-MAIL NOTICES.
ALL INFORMATION WILL NOT BE DISTRIBUTED OR SHARED WITH ANY OTHER ORGANIZATION.
SALUTATION
FIRST NAME
MIDDLE NAME (OR INITIAL)
LAST NAME
DESIGNATIONS (IE:CFE, CPA)
HOME
OFFICE
NAME OF COMPANY
TITLE
ADDRESS – STREET
SUITE/ APT #
CITY
STATE
ZIP CODE
PHONE NUMBER
FAX
CELL PHONE
EMAIL ADDRESS
COMPANY WEB URL
OCCUPATION
SPECIALIZATION
Are You Presently A CFE?
Yes No
If So, Enter Your Number
Are You A Member of the Association?
Are You a NYC Chapter Member?
MAIL PREFERENCE HOME E-MAIL OFFICE E-MAIL
Select your Membership Type
Chapter Member $35.00. Must Be A Certified Fraud Examiner Dual Member $30.00. A CFE Who Is A Paid Member of the LICFE (payment of $30.00 to each Chapter) Chapter Associate $40.00. Not Required To Be A CFE (You must be a Associate Member of the National Chapter). Student Member $15.00. Proof Of Full-Time (Resident) Student Status Required
Dues Are For The Calendar Year. Annual Dues Are Due December 15th, For The Next Year.
IMPORTANT NOTICE: The Board of Directors has voted that anyone who paid their dues during the calendar year of 2007, is considered paid for 2008.
Payment Information
Payment Method:
Paypal Check Money Order If paying by check, please Make Your Checks/Money Orders Payable to "NYCFE", then print this page and mail your completed application, check and a business card to Send checks to our treasurer:
KRISTEN HENRION, CFE 128 CARROLL STREET - #2 BROOKLYN, NY 11231
I certify that the above is true and correct to the best of my knowledge. I have never been convicted of a felony offense. Falsification of any information on this application is grounds for denial or revocation of Membership. If this application is accepted, I agree to abide by the Bylaws and Code of Professional Ethics of the Association of Certified Fraud Examiners, and the New York Chapter of the Association. Membership is a privilege and not a right.
Membership is subject to the approval of the Board of Directors at their sole discretion. By submitting this application, the applicant hereby applies for membership in the New York Chapter of the Association of Certified Fraud Examiners and knowing that this association relies on the veracity of the applicant's statements herein as a condition and retention of membership, furnishes the above information:
Check the box at left to indicate that you agree with the above statements
(You must check the box above in order to submit your application.)
IF YOU WOULD LIKE TO PRINT THE APPLICATION FOR YOUR FILES, PRINT IT BEFORE YOU PRESS THE SUBMIT BUTTON.
RONALD SEMARIA, CFE,DABFE,FACFEI,CSC,CHS-III 1408 East 66 Street, Brooklyn, NY 11234 Phone: (718)531-1105 E-Mail: info@nycfe.org Internet: http://www.nycfe.org
