NABPP Membership Application
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Applicant Information
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Name:
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Business
Address:
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City:
State:
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Business Information
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Work Address:
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City:
State:
ZIP:
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Phone:
Email:
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General Information
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Have you ever prepared a
bankruptcy? YES NO
If so, how many have you prepared?
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Have you yourself filed
bankruptcy? YES NO
What district do you plan to prepare in?
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Have you had any special
education that will assist you in petition preparation? YES NO
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Course description:
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Certificate received? YES NO
Year
completed:
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Please list
any additional course study or training:
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Are you currently working in
a field that will accommodate a bankruptcy petition business? YES NO
Do you plan to integrate the two? YES
NO
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If so, what
field do you work in?
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What is the
estimated population of your surrounding area?
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Additional Information
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Do you have
any additional information you would like to share with us?
(If you need additional space please attach
pages as needed)
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Applicant Signature
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For virtual applications please type your name
below. All others, signature required.
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Signature of Applicant:
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Date:
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OFFICE USE ONLY
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