Emeritus Membership Application

Emeritus membership is available to retired, Certified SFC members. An application is required for consideration of the change to Emeritus status. Please complete this form and send it to the Membership Committee Chair ().

Note: An Emeritus member who re-enters the workforce will be required to notify the SFC Membership Committee Chair for reclassification as a Certified member.

Application Date: Click here to enter a date.

Applicant Contact Information
Name / Click here to enter text. /
Home Address / Click here to enter text. /
City / Click here to enter text. /
State and Zip Code / Click here to enter text. /
Contact Phone / Click here to enter text. /
Email / Click here to enter text. /
Please answer the following questions:
Certified SFC Member since / Click here to enter a date.
Date of Retirement / Click here to enter a date.
Career History: Please provide the last 4 jobs or 10 years employment history.
List most recent first.
1. / Employer’s Name / Click here to enter text. /
Employer’s Address / Click here to enter text. /
City / Click here to enter text. /
State and Zip Code / Click here to enter text. /
Business Phone / Click here to enter text. /
Your Title / Click here to enter text. /
Type of Business / Choose an item. /
Dates of Employment / From: Click here to enter a date.
To: Click here to enter a date.
Name of Immediate Supervisor / Click here to enter text. /
Contact Information of Supervisor / Click here to enter text. /
Contact Information of Personnel Manager / Click here to enter text. /
Other Contact Information: to verify employment if above spaces have not been satisfied / Click here to enter text.
Click here to enter text.

Page 1 of 2

Career History: (cont’d)
2. / Employer’s Name / Click here to enter text. /
Employer’s Address / Click here to enter text. /
City / Click here to enter text. /
State and Zip Code / Click here to enter text. /
Business Phone / Click here to enter text. /
Your Title / Click here to enter text. /
Type of Business / Choose an item. /
Dates of Employment / From: Click here to enter a date.
To: Click here to enter a date.
Career History: (cont’d)
3. / Employer’s Name / Click here to enter text. /
Employer’s Address / Click here to enter text. /
City / Click here to enter text. /
State and Zip Code / Click here to enter text. /
Business Phone / Click here to enter text. /
Your Title / Click here to enter text. /
Type of Business / Choose an item. /
Dates of Employment / From: Click here to enter a date.
To: Click here to enter a date.
Career History: (cont’d)
4. / Employer’s Name / Click here to enter text. /
Employer’s Address / Click here to enter text. /
City / Click here to enter text. /
State and Zip Code / Click here to enter text. /
Business Phone / Click here to enter text. /
Your Title / Click here to enter text. /
Type of Business / Choose an item. /
Dates of Employment / From: Click here to enter a date.
To: Click here to enter a date.

Page 1 of 2

All the above has been completed to the best of my ability.

Date: ______

I, ______, promise to inform the SFC of any changes in my employment status.

(your signature)

Please email a pdf version of this completed applicationto .

A receiptconfirmation reply will be sent to your email address.

Page 1 of 2