Membership Application
TO RENEW OR JOIN COMPLETE THE FORM BELOW BY 10/31/2010, AND RETURN WITH YOUR ANNUAL DUES CHECK FOR $60.00 PAYABLE TO: "DCEPC" at P.O. BOX 2083, MEDIA, PA 19063
NAME________________________________NEW MEMBER______
FIRM________________________________________________
TITLE: (Circle one) CPA CLU CFP ChFC ESQ
TRUST BANKER OTHER________________________
ADDRESS_______________________________________________
_________________________________________________________
PHONE___________________ FAX_________________________
Email____________________________________________________
My choice for Meeting Notices to be sent:
Email_________ Regular Mail________
Be certain all information is EXACTLY as you want it to appear in the 2010-2011 DELAWARE COUNTY ESTATE PLANNING COUNCIL DIRECTORY
If applicable, for new members, please indicate the name of the recommending member:________
For more information, please contact
Donna Lee Willis, Executive Director
PO Box 2083
Media PA 19063
610-565-3800 ext. 877