Council Applicant Endorsement Form

Council Applicant Endorsement Form

Welcome to the Estate Planning Council of Long Island's New Applicant Endorsement Form. You have been designated as an Endorsement reference for one of our prospective members. Please complete the form below.
Endorsement of (Please enter the name of applicant)*

First NameLast Name
Your Name*

First NameLast Name
Date*

MonthDayYear
Date
Your Email Address*
example@example.com
Please include specific details of your personal knowledge of the applicant's estate planning experience. Please type and attach additional pages if needed*
File Upload (if applicable)

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Endorser Signature*

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Secondary Endorser

First NameLast Name
Secondary Endorser Email Address*
example@example.com
Secondary Endorser Signature*

Clear
Reminders: By submitting this form, you agree that the information provided is accurate and truthful to the best of your knowledge. Please provide relevant and accurate information to support the cause.
Applicant Email
example@example.com
Should be Empty: