Online Membership Application

Welcome and thank you for applying for Membership in APIC!

All required fields must be completed in order for your application to be considered. If applying as a new Team, each Team member representative needs to complete an application and consistently use the name of the Team on the application.

*Required Fields
Prefix:
*First Name:
MI:
*Last Name:
Suffix:
Nick Name:
*Citi/SB Title:	(e.g. Senior Vice President)

TYPE OF MEMBERSHIP APPLYING FOR:
Voting Associate (non voting)
Individual	- A Single Qualifying FA. (Select Appropriate Professional Designation)
Mandatory Titles
Team	Qualifying FA Member of a Team (Select Appropriate Professional Designation)
Mandatory Titles

Team Associate	in an established, "Smith Barney Team / Citi Team" with a Voting member.
Firm Associate	Employee of Smith Barney or a Citigroup-affiliated company.

APIC Team Membership	Is this a New or Existing Team Currently in APIC: New APIC Team Membership Existing Team Membership
Name of Team:
Name of Primary Contact:	(must be either a Current Voting member or applicant)
Please note any other additional information that would be useful in considering your membership application.
Notes:

Business Related Titles
If "Other" is checked in business related titles, please fill in other title.
Office Address
*Office Street Address:
City: State: *Zip:

Mailing Address (If different from Office Address)
Office Mailing Address:
City: State: Zip:

*Direct Phone: Fax: (xxx)xxx-xxxx (xxx)xxx-xxxx
*Smith Barney Email Address:
*Division:
*Region:
*Branch #
Next Gen Sign On
*Office Wire Code
*Primary FA Phone No.
Client Services Assistant Name
FA Since:	(enter as yyyy)
Smith Barney/CitiGroup Since:	(enter as yyyy)
*Job Function:
APIC Membership is a collaborative, participatory, and working organization. Committee involvement is the cornerstone of our union. We are seeking those that embody these principals and have a willingness to serve, share and teach in that spirit. We do this is through committee involvement. Please select at least one committee that you plan to be active on.
*Committee Preference:
*Voting Member Sponsor:	This is a list of APIC's current Voting members who are eligible to serve as your Memberhip Sponsor. You must select one of these individuals to complete the application process.
* Branch Manager's Email address:	An email will be sent to your Branch Manager confirming your good standing within the firm.
By applying for APIC Membership I acknowledge that I will abide by the APIC Code of Ethics and APIC StreetSmarts Usage Policy. Membership is not transferable to another person. To transfer from Associate (non-voting) to Voting membership status requires submitting a new membership application. Former members may be reinstated upon written request and are not required to submit a membership application, unless they were previously an Associate member. By submitting this application I affirm that the information provided herein is true and accurate, and that APIC has my consent to obtain any legal and/or compliance information in regard to my employment at Smith Barney or any other employer. APIC primarily communicates with its members through various electronic formats, including email and fax. As a member you agree to provide your Smith Barney email address and consent to receiving electronic communications from APIC as a condition of membership. A request to opt-out will invalidate your membership. Thank you and welcome! *Please enter your name below signifying that you have read and agree to the above statement. APIC will notify you of the acceptance of your application and then invoice you for your membership dues.

Online Membership Application

John Halperin Phone: 818-382-5710 Email: john.m.halperin@smithbarney.com

John Halperin
Phone: 818-382-5710
Email: john.m.halperin@smithbarney.com