Membership Application – Attorney Date* Name* FIRM* Address Phone* Email* Website Address Degrees held & college/university: Degree* date rec’d* Degree date rec’d State(s) in which you are currently licensed to practice: Good standing with NC State Bar?YesNo Years in practice: Background and Experience in Family Law. Include nature of experience sufficient to meet requirements of membership and percentage of practice devoted to family law: Collaborative divorce law training: date rec’d location of training: hours attended: instructor: Your business name, address and phone number will be published on CCDP website (https://charlottecollaborativedivorce.com) but not your email address (that is for sharing of information among members only). You will be forwarded any emails that originate from your profile page on the CCDP website. ANNUAL DUES: $250.00 PLEDGE I hereby apply for membership in the Charlotte Collaborative Divorce Professionals (“CCDP”) and request that my name be included in CCDP’s List of Collaborative Professionals. As a condition of continued membership, I certify that I will: Support the mission of CCDP and the goals of collaborative practice, including, but not limited to: promote the resolution of conflicts outside of litigation through the collaborative team process; educate members, the profession and the community about collaborative law, and train professionals in the process. Comply with all rules, protocols and procedures of CCDP as developed from time to time. Comply with the terms of every stipulation and agreement that I sign in the Collaborative Process. Complete 4 hours of annual workshop sponsored by CCDP or CLE, workshop or equivalent for collaborative, mediation, alternative dispute resolution, communications or similar programs. Attend at least 50% of CCDP meetings per year. If unforeseen circumstances prevent attendance at 50% of meetings, then I must perform 2 hours of time in committee work (e.g., websites, membership, program committee, publications/media), membership tasks approved by the Executive Board, or speaking engagements related to CCDP’s mission. Timely pay annual CCDP membership dues. Signature Date* Δ