Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form.Select Your Application Type *CFCIA Member SinceEmail *Occupation *Government Employed InvestigatorCorporate InvestigatorCurrent Employer Name/Agency (List Past 5 Years) *Employer Name/Agency Address *Address Line 1Address Line 2City— Select state —AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodePosition/Title *Start Date *End DateSupervisor's Name (for Verification) *Supervisor's Phone *Prior Employer Name/Agency (if at current position < 3 years) Prior Title, Start and End Date, AddressPrior Supervisor's Phone Prior Supervisor's Name (for Verification) Professional Certifications (List Title, Organization and Year obtained for each certification held)EDUCATIONGED/High School GraduateSome College or Trade SchoolCollege DegreeList College or Trade School (i.e. Degree Earned, School/University, Field and Year of Completion)List Fraud/Financial Crime Specific Training (i.e. Title, Organization, Year and Hours)Court Qualified Expert in Fraud *N/AYesIf yes, select typesCivil CourtCriminal CourtLocal/State CaseFederal CaseDo you Provide Training to Others on Fraud? If so, enter topicsI affirm the forgoing is true and accurate to the best of my knowledge. I understand any intentional misstatement of fact is grounds for removal from CFCIA. I understand the forgoing information is subject to verification by CFCIA’s leadership or designees thereof. I understand the CFI designation is specific to the CFCIA and is contingent on passing the written examination and a panel review by the certification committee. I understand this packet is subject to review by people outside of CFCIA pursuant to a court order or other process of law. I further understand if awarded the CFI designation, I will be required to keep my CFCIA membership active and also attend the required hours of continuing education and/or training related to my position per year. Proof of this may be requested by CFCIA. Failure to keep my CFCIA membership active and/or failure to attend the required training hours per year of required training may result in nullification of my CFI designation. I also understand the guidelines for retention of the CFI designation may be changed by the CFCIA Executive State Board at any time. I agree to adhere to any changes in requirements by the CFCIA Executive State Board to maintain my certification. I also understand and agree that any and all material, including study material and exam questions are the property of the California Financial Crimes Investigators Association and may not be release or shared to anyone within or out of the organization without proper written consent. *AFFIRMATIONSignature * Clear Signature Date *Select you application type *New Member – $40.00Renew – $30.00PayPal Commerce *PayPal CheckoutCredit CardCard NumberExpiration DateSecurity CodeCard Holder NameSubmit