CPCU Society Candidate Member Application

Industry professionals who have credit for at least four parts of CPCU are eligible for Candidate membership status in the CPCU Society. Candidate members must be actively working toward completing the CPCU (take at least one exam per year), and agree to comply with the Society’s Code of Ethics.

Annual dues for candidate members are 50% of the combined national and chapter dues.

Candidate Member Benefits

Professional Development & Education Benefits / Career Development & Networking Benefits
§  25% discount for Institutes study materials
§  35% discount for unlimited online CE from CEU.com
§  14 free selected interest group webinars each year
§  Free access to additional webinars on a quarterly basis
§  Free access to selected Institutes online content on quarterly basis
§  Free subscriptions to CPCU Society publications to stay current on emerging trends and issues:
§  Access to more than 100 on-demand technical insurance and management webinars at a discounted rate / §  Access to specialized jobs database
§  Invitations to connect with local and national experts and speakers via the CPCU Society Annual Meeting and Seminars, chapter meetings, and interest group events
§  Opportunity to develop and demonstrate leadership and management skills within the CPCU Society, chapters, and interest groups
§  Grow your professional network through association with 24,000 industry professionals via local chapters and interest groups
§  Ability to contribute to the industry and the local community via mentoring, community outreach, and service programs
§  Access to the “members-only” section of the Society’s Website, including unique Member Resources

Candidate members receive all the benefits of full membership except for complimentary access to The Institutes online suite of CPCU courses.

CPCU Society Candidate Member Application

Planned CPCU Completion Date (Month and Year):______ ______

Name: ______

Employer: ______

Position/Title: ______

Preferred Mailing Address:______

______

Is Preferred Address? r Home r Office

Preferred Phone: ______

Is Preferred Phone? r Home r Office r Mobile

Preferred E-mail: ______r Personal r Business r Other

Alternate E-mail: ______r Personal r Business r Other

Annual Society Candidate Dues: $100.00

Chapter Name:______Dues*: $ ______

TOTAL DUES: $ ______

Preferred Interest Group:______$0.00

r Check Enclosed (payable to: CPCU Society) r Please charge my: r VISA r MasterCard rAmerican Express

Card Number: ______Exp. Date: ______

Signature: ______

Please return this form to: CPCU Society, 720 Providence Road, Malvern, PA 19355-0709, USA

Telephone: (800) 932-2728 Fax: (610) 725-5969

*See chart below for chapter dues/candidate member rates

Interest Groups:

Agent & Broker | Claims| Coverage, Litigators, Educators & Witnesses (CLEW)| IT |

Excess, Surplus, & Specialty Lines| International Insurance |Leadership & managerial Excellence|

Loss Control| Personal Lines |Regulatory & legislative| Reinsurance |Risk Management| Underwriting

Alabama
Central Alabama (Montgomery)
Gulf Coast (Mobile)
North Alabama (Birmingham) / $7.50
$25
$37.50 / Mississippi
Mississippi Magnolia (Jackson) / $17.50
Alaska
Alaska (entire state) / $37.50 / Missouri
Central Missouri (Columbia)
Kansas City
Ozarks (Springfield)
St. Louis / $22.50
$37.50
$15
$25
Arizona
Arizona (entire state) / $75 / Montana
Montana (entire state) / $12.50
Bermuda / $70 / Nebraska
Nebraska (Lincoln) $60
Omaha $50 / $30
$25
California
California El Camino (San Fernando Valley)
California Golden Empire (Bakersfield
Golden Gate (San Francisco)
Los Angeles
Mt. Diablo California (Stockton)
Orange Empire
Sacramento Valley
San Diego
San Gabriel Valley
Santa Clara Valley (San Jose) / $37.50
$25
$37.50
$47.50
$25
$42.50
$25
$37.50
$32.50
$25 / Nevada
Las Vegas, Nevada
Sierra Nevada / $12.50
$12.50
Colorado
Colorado (Denver)
Pikes Peak (Colorado Springs) / $37.50
$45 / New Hampshire
New Hampshire (entire state) / $37.50
Connecticut
Connecticut (Hartford) / $25 / New Jersey
Central Jersey (Trenton)
New Jersey (Newark) / $12.50
$25
Delaware
Brandywine Valley Del/PA / $30 / New Mexico
New Mexico (entire state) / $17.50
District of Columbia / $57.50 / New York
Buffalo
Long Island
New York (New York City)
Northeastern New York (Albany)
Rochester
Southern Tier of NY State (Binghamton)
Syracuse
Utica
Westchester / $25
$40
$37.50
$15
$30
$5
$20
$17.50
$20
Europe / $37.50 / North Carolina
Charlotte
Eastern North Carolina (Raleigh)
Piedmont North Carolina (Greensboro) / $25
$25
$15
Florida
Central Florida (Orlando)
Cypress Gardens (Winter Haven)
Florida Gold Coast (Palm Beach)
Florida Suncoast (Tampa)
North Central Florida (Gainesville)
North Florida (Jacksonville)
South Florida (Miami)
Southwest Florida (Fort Myers) / $20
$42.50
$20
$27.50
$25
$25
$40
$25 / North Dakota
North Dakota Roughrider
(entire state) / $10
Georgia
Atlanta
Middle Georgia (Macon)
Savannah, Georgia / $50
$22.50
$12.50 / Ohio
Akron-Canton
Cincinnati
Cleveland
Columbus
Dayton-Miami Valley
Grand Lake (Lima)
Mahoning-Shenango Valley (Youngstown) / $40
$42.50
$50
$35
$10
$12.50
$7.50
Hawaii
Hawaii (entire state) / $25 / Oklahoma
Central Oklahoma (Oklahoma City)
Northeastern Oklahoma (Tulsa) / $50
$62.50
Idaho
Idaho (entire state) / $15 / Pennsylvania
Allegheny (Pittsburgh)
Central Pennsylvania (Harrisburg)
Northeastern Pennsylvania (Scranton)
Pennsylvania Dutch (Lancaster)
Philadelphia
Presque Isle, Pa (Erie)
Valley Forge / $12.50
$10
$10
$17.50
$40
$15
$12.50
Illinois
Central Illinois (Bloomington)
Chicago
Chicago-Northwest Suburban
Chicago-West Suburban
Land of Lincoln (Springfield)
Rock Valley (Rockford) / $17.50
$50
$25
$37.50
$15
$15 / Puerto Rico
Puerto Rico (entire territory) / $25
Indiana
Central Indiana (Indianapolis)
Northern Indiana (Ft. Wayne) / $50
$22.50 / Rhode Island
Rhode Island (entire state) / $17.50
Iowa
Cedar Valley (Cedar Rapids)
Iowa (Des Moines)
Quad City (Davenport) / $17.50
$20
$15 / South Carolina
South Carolina (Columbia)
Upstate South Carolina (Greensville) / $12.50
$17.50
Japan$50 / $25 / South Dakota
Sioux Empire (Sioux Falls)$30 / $15
Kansas
Wichita / $25 / Tennessee
Great Smoky Mountains (Knoxville)
Greater Chattanooga
Memphis
Mid-Tennessee (Nashville) / $37.50
$20
$50
$27.50
Kentucky
Kentucky (Louisville)
Kentucky Bluegrass (Lexington) / $10
$12.50 / Texas
Alamo (San Antonio)
Central Texas (Austin)
Dallas
El Paso
Fort Worth
Heart of Texas (Waco)
Houston / $50
$50
$25
$50
$62.50
$50
$67.50
Korea / $15 / Utah
Utah (entire state) / $37.50
Louisiana
Bayou (Baton Rouge)
Deep South (New Orleans)
Shreveport / $10
$25
$50 / Vermont
Vermont (entire state) / $20
Maine
Maine (entire state) / $12.50 / Virginia
Blue Ridge (Roanoke)
Central Virginia (Charlottesville)
Greater Richmond
Tidewater, Virginia (Norfolk) / $15
$12.50
$20
$32.50
Maryland
Maryland (Baltimore) / $25 / Washington
Pacific Northwest
Spokane, Washington / $42.50
$50
Massachusetts
Boston
Central Massachusetts (Worcester) / $32.50
$25 / West Virginia
No chapters
Michigan
Greater Detroit
Mid-Michigan (Lansing)
Northeastern Michigan (Saginaw)
Southwestern Michigan (Kalamazoo)
Western Michigan (Grand Rapids) / $25
$13.75
$7.50
$15
$15 / Wisconsin
Dairyland (Madison)
Greater Milwaukee
Northern Wisconsin (Wausau)
Wisconsin-Fox Valley (Appleton) / $25
$27.50
$20
$30
Minnesota
Minnesota (entire state) / $24.50