THE CENTER FOR PRINCIPLED FAMILY ADVOCACY

WWW.FAMAD.COM

2010 MEMBERSHIP APPLICATION
1. / NAME:
LAST NAME / FIRST NAME / MIDDLE INITIAL
2. / OFFICE ADDRESS:
STREET ADDRESS / SUITE NUMBER
CITY / STATE / ZIP CODE
3. / TELEPHONE NUMBER: / 4. FAX NUMBER:
AREA CODE / AREA CODE
5. / E-MAIL ADDRESS:
6. / PROFESSION:

SUPREME COURT REGISTRATION NUMBER (ATTORNEYS)

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Circle Membership Class

Class A: Attorneys

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Class B: Family Law Related Professionals

(Psychologists, Mediators, Business Valuators, etc.)

Class C: Court Personnel (excused from membership fee)

I understand that by signing and submitting this application, I am affirming to the Executive Committee of the Center the following:

1.  That I have professional liability insurance in force and effect as of this date;

2.  That I understand that the CPFA is dedicated to returning to individual clients and families control over the decision as to the process(es) to be utilized in family dispute resolution;

3.  That as a member of the CPFA, I commit to identifying to my clients all of the reasonable and appropriate family dispute resolution processes presently available; including, but not limited to, principled negotiation, collaboration, mediation, arbitration and litigation;

4.  That as a member of the CPFA, I commit that if another member of the CPFA is engaged in the representation of an opposing party or interest in the family dispute or matter, I will meet with that member, and our clients where appropriate, within a reasonable time to identify and establish the process(es) by which the family dispute or matter will be resolved;

5.  That I commit to the following: (a) attend a minimum of four meetings annually; (b) completion of the Basic Collaborative Training within twelve months of membership; (c) participation in a minimum of one CPFA approved CLE per year. Failure to meet the foregoing criteria will result in loss of membership. Deviation from said requirements shall be handled in a case-by-case basis by the Executive Committee.

SIGNATURE OF APPLICANT DATE AMOUNT OF MEMBERSHIP FEE ENCLOSED

ANNUAL MEMBERSHIP FEE: $250.00 - Class A Membership Fee (Class A members through December 31, 2010) $150.00 - Class B Membership Fee (Class B members through December 31, 2010) $100.00 - One-time processing fee (new Class A members only).

PLEASE MAKE YOUR CHECK PAYABLE TO "THE CENTER FOR PRINCIPLED FAMILY ADVOCACY"
Please Remit Payment to:
Center for Principled Family Advocacy
c/o Sarah Gabinet, Treasurer
1375 East Ninth Street, 20th Floor
Cleveland, Ohio 44114

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