The FSCP Designation Application Applicant: Information provided on this form must be verified by a seal from your local Association. Please allow 15 weeks for processing. Please type or print legibly. The name on the diploma will be printed as requested on this application. This application should be submitted only upon successful completion of the FA Courses (2 EU’s each), the FA 290 Ethics and the FP 99 Course & Examination.Last Name *First Name *Middle Initial *Mailing AddressOffice Phone *Office FaxCARAIFA ID # *Date of Birth *Email Address *Type legal name for engrossing on diploma *(First, Middle, Last)IMPORTANT: CARAIFA/Local Association dues must be paid in the year of conferment in order to qualify for FSCP.I belong to the following AssociationA. I have successfully completed the following FA courses (2 EU’S EACH) in the years indicated:(FA 201) Techniques for Exploring Personal Markets *(FA 202) Techniques for Meeting Client Needs *(FA 251) Essentials of Business Insurance *(FA 257) Essentials of Life Insurance Products *(FA 261) Foundations of Retirement Planning *(FA 271) Foundations of Estate Planning *B. I have completed and passed the examination for:FA 290 Ethics for the Financial Services Professional;Please provide the following information regarding your completion of the ethics course requirement.How did you complete your ethics course requirement ?SeminarSelf StudyName of moderator *Date *Location *C. I have completed and passed the examination for:FP 99 FSCP Certification Course & Exam:Please provide the following information regarding your completion of the certification exam requirement.Name of moderator *Date *Location of exam sitting *D. Please add my name to the FSCP Online Directory after my application has been approved.Please select oneYesNoE. Please contact me regarding Moderator opportunities.Please select oneYesNoTo the best of my knowledge and belief, the statements made on this application are true and correct. In consideration of the award of the designation to me, I acknowledge and agree that CARAIFA and The American College shall jointly have the authority to (1) establish and from time to time change the conditions under which the designation is to be awarded and used, and (2) suspend, revoke, or modify in writing my privilege to use the designation for good cause, of which they shall be the sole and final judge. I further agree that in addition to my local Association’s records, a decisive factor in the determination of my eligibility for the designation shall be the official records of CARAIFA. I also promise that I will not use the designation except as authorized pursuant to this agreement.Signature *Date * Send Message
