Form

Event Month: May 2025 (Spring Mixer)

Event Registration Form

Attendee Information:

Have you purchased an annual chapter membership pass for 2025?*

Please Note: Chapter membership codes not required to register. Holding the CEPA credential does NOT automatically qualify you for an annual chapter membership code, as this must be purchased separately. For more information on chapter membership, please contact your local chapter leadership team.

Yes

First name*

Last name*

Advisor Type*

Company name*

City*

State/Region*

Email*

Referred to Chapter by*

IMPORTANT: After completing this form, you will receive confirmation of your registration. Please reach out to memberexperience@exit-planning-institute.org with questions.

Complete your request by clicking below.