COLLABORATIVE PROFESSIONALS
OF CENTRAL PENNSYLVANIA
MEMBERSHIP AGREEMENT
I,
, hereby agree to
become a member of the Collaborative Professionals of Central Pennsylvania (CPCP) for
calendar year
. I understand that my membership is subject to the terms
and conditions set forth in this Agreement and such other terms and conditions as may
hereafter be adopted by the CPCP.
1.
I certify that I have met, or will meet as indicated, the following mandatory
criteria for membership in the CPCP:
A.
Please initial the appropriate statement:
I am an attorney and an active member of the Pennsylvania
Bar.
I am a licensed mental health professional in good standing
in Pennsylvania.
I am a mental health professional with a minimum of a
Master’s Degree from an accredited institution.
I am a financial professional with a license or designation in
good standing in one of the following: (Please specify)
CFP – Certified Financial Planner
CPA – Certified Public Accountant
CMA – Certified Management Accountant
ChFC – Chartered Financial Consultant
CDFA – Certified Divorce Financial Analyst
or equivalent in Pennsylvania
I am a collaborative specialist (realtor, banking professional,
appraiser, insurance agent). Please indicate title or
credentials.
If applicable, my NMLS# is
B.
Prior to my initial application for membership in the CPCP, I successfully
completed a two (2) day training in Collaborative Practice which was at
least twelve (12) hours in length.
C.
I will be a member of IACP while I am a member of CPCP.
Please initial the appropriate statement:
__________ I am a member of IACP and my membership expires on
___________.
__________ I am joining IACP at the time of this application.
D.
I have completed or will complete, within twelve (12) months of joining
CPCP, a minimum of twenty-four (24) hours of mediation training. I
understand that if I do not complete the training by the end of the twelve
(12) months, I will no longer be a member and my name will be removed
from all materials and the website of CPCP, as well as the CPCP listing on
the IACP website.
Please initial the appropriate statement:
_
_____
I have completed the required mediation training.
I have not yet completed the required mediation training,
however, I will complete this requirement within twelve (12)
months of joining CPCP and will notify the Membership
Coordinator as soon as my training is complete. (This is only
for those joining CPCP for the first time.)
E. (For attorneys and mental health professionals)
I have malpractice/liability insurance coverage in the minimum amount of
$200,000.00 per incident and agree that I will continuously maintain
such minimum coverage throughout the course of my membership in the
CPCP.
2.
3.
I understand that all members are expected to volunteer their time and talents
for CPCP projects and the ongoing work of the membership and that the
following criteria are recommended for all members of CPCP:
A.
Continuing education in mediation and collaborative practice including
interdisciplinary training.
B.
The attendance at the monthly CPCP General Membership meetings.
C.
The participation in committee meetings and activities of CPCP.
I acknowledge that the CPCP has adopted the following conditions to maintain
membership in good standing and agree that I will comply with each of these
conditions:
A.
All collaborative law cases with other members of CPCP will be conducted
in accordance with all rules and protocols of the CPCP as may be adopted
from time to time, including without limitation utilization of the CPCP
Collaborative Law Participation Agreement and other forms developed
and adopted by the CPCP for use in collaborative law cases.
B.
I will follow all of the standards of practice adopted by the CPCP for
collaborative law cases including the following:
i.
(For attorneys and mental health professionals)
Inclusion of language in my retainer agreement/engagement letter
that limits my representation of the client to the collaborative
process.
The
client
must
agree
in
the
retainer
agreement/engagement letter that as her or his attorney or mental
health professional, I must withdraw representation if the
collaborative process is terminated and I cannot be called as a
witness for either party in Court.
(For financial professionals)
Written notice to the client that I cannot be called as a witness for
either party in Court if the collaborative process is terminated.
ii.
Prompt production of full and fair discovery.
iii.
Advance preparation with clients and collaborative professionals
for all collaborative meetings.
iv.
Timely preparation of collaborative meeting agendas and meeting
session minutes as allocated between collaborative professionals.
v.
Prompt debriefing with client and collaborative professionals
following collaborative meetings.
C.
I have paid or will pay to the CPCP a non-refundable initiation fee of Three
Hundred Dollars ($300.00), and an annual non-refundable membership
fee as established by CPCP pro-rated quarterly for the first year of
membership based on the date of my initial application for membership. I
understand that the amount of the annual dues will be adopted each year
by the CPCP and I agree to make payment of such within thirty (30) days
of the adoption. I understand that a portion of the initiation fee will be
used to pay my membership dues in the IACP from the date of my initial
membership in the CPCP.
D.
Upon adoption by the CPCP for an additional assessment during any
calendar year, I agree to make payment of the assessment within thirty
(30) days of the adoption.
4.
I acknowledge that my membership in the CPCP must be renewed each calendar
year no later than January 31 and that my current membership ends on
December 31 of this year.
5.
I agree that I will hold myself out as a member of the CPCP only while my
membership is in good standing.
6.
I understand that I may terminate my membership in the CPCP by notification of
such in writing to the Membership Coordinator and that upon such termination
my name may be removed from the CPCP member list, brochure, website and
any other IACP or CPCP marketing or education materials.
7.
I acknowledge that my membership in the CPCP may be terminated by the CPCP,
upon recommendation of the Policy and Procedure Committee, if I fail to meet
the criteria or conditions for membership as set forth in this Agreement or
hereafter adopted by the CPCP and in the event my membership is terminated by
the CPCP, my name may be removed from the CPCP member list, brochure,
website and any other CPCP marketing or education materials including the
CPCP listing on the IACP website.
8.
I agree that any dispute related to my membership shall be submitted to the
Policy and Procedure Committee for resolution in accordance with guidelines and
procedures adopted by the CPCP.
By signing this Membership Agreement, I certify that the statements made herein
are true and correct.
Dated:
signature of member
Please complete the following as you would like it to appear on our Website and in our
Inserts.
Print name and title (ie. M.S., LPC, CPA, CVA, CFF, Esq.)
Address
E-mail address
Website
Phone Number
Revised October 2012