Palmetto Chapter Membership Application

Are you a member of the national ACFE?

YESNO

PLEASE NOTE: In order to become a member of the state chapter, you must first be a member in good standing of the national association. If you answered NO above, please join the national association first by visiting www.acfe.com.

If you answered YES above, indicating that you are currently a member in good standing of the national ACFE, please check below whether you are a CFE or an Associate member of the ACFE:

CFEAssociate

PLEASE NOTE: Annual renewal by application is required each year in order to remain a member in good standing of the SC Chapter.

Name

First NameLast Name

Company Name

Position/Title

Company Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Phone Number

Area CodePhone Number

Email

example@example.com

Would you be interested in assisting the SC chapter in any of the following capacities (check all that apply)?

Board MemberOfficer (President, Vice President, Secretary, Treasurer)Teaching/TrainingHosting and coordinating a training event in your local cityOther

ANNUAL DUES (Annual dues run per calendar year. Please check the membership level below that you will be joining under - you will be responsible to pay the dues associated with that membership level):

Regular Membership - $50.00Student Membership - $10.00Law Enforcement/Government Employee $30.00

How will you be paying your annual dues?

Credit cardMailing a check

For Credit Card Payments - please click ONLY ONE of the below that corresponds to your membership level to make payment (when you hit the "Submit" button below, you will be directed to our payment site to process your credit card):

Regular Membership($50.00 one-time payment)

Student Membership($10.00 one-time payment)

Law Enforcement/Government Employee Membership($30.00 one-time payment)

For Check Payments - please make checks payable to "Palmetto Chapter ACFE" and mail along with a copy of your completed membership application to:

Palmetto Chapter ACFE, P. O. Box 6468, West Columbia, SC 29171