Application for Affiliation - NAPFA

Form ADV Include as Attachment A a copy of your current Form ADV and all Schedules. If you are not registered, attach a
detailed explanation as Attachment A. State the date, status and file number of your registration as an investment adviser or
investment adviser representative.
*Not needed if employed by a firm with at least one other NAPFA member.
Regulated by SEC or State
File number
Date of current registration
Status
Education Provide the name and location of each accredited institution from which you have received a degree, showing the
date and discipline of each degree. An applicant for Student Affiliation status should provide information concerning the
degree/designation that is expected to be received and when applicant started in the educational program. As Attachment B,
an applicant for Student Affiliate status should include evidence of candidacy in a financial planning or related curriculum.
Name of Institution Location Degree and discipline Year conferred
Employment Please describe your current employment, including title, institution, length of service and a general description
of your duties.
Affiliate Status Please check the category appropriate to your application.
Financial Services Affiliate. By signing this document, an applicant certifies that he or she is a Fee-Only professional
in a financial services or related industry.
Academic Affiliate. By signing this document, an applicant certifies that he or she is a faculty member in a financial
planning program or a related field at an accredited institution of higher learning.
Student Affiliate. By signing this document, an applicant certifies that he or she is a student enrolled in an academic
course of study in pursuit of a degree/designation that will lead to a financial planning career. The student may be employed
by a Fee-Only financial planning firm. An applicant further certifies that he/she is a degree/designation candidate at the
accredited institution of higher learning named above. Applicants for this category of affiliation are not required to have this
document notarized.
Additional Information If you believe that additional information would be helpful to the NAPFA Membership Committee in
its evaluation of your application, please feel free to include that information as Attachment C.
September 2006
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