Membership Application

Dear Compliance Professional:

Thank you for visiting our website and your interest in the Chicagoland Compliance Association, Inc. (CCA). CCA is a professional organization established to assist Compliance professionals like you to keep abreast of regulatory compliance developments.

CCA is nationally known for presenting breakfast seminars and an all-day conference led by recognized Compliance experts speaking on current topics of interest. CCA also provides a forum for networking and knowledge-sharing with other Compliance professionals. In addition, participation in CCA events can provide continuing education credits for those pursuing or maintaining professional certification. Why not join CCA and take advantage of these benefits?

The membership levels and applicable dues for 2009 CCA memberships are based on the calendar year and are as follows:

Financial Institutions with Assets of $1 Billion or more: $100
Financial Institutions with Assets less than $1 Billion: $60
Service Membership (Vendors, Non Financial Institutions): $100

By submitting the application below by January 31, 2009, you will be able to take advantage of the reduced registration fees available to members for all 2009 CCA events*. If you elect not to join, you can still attend any 2009 CCA event by paying the non-member registration fee.

					
						All registrations received by January 31, 2009 will be automatically entered in a drawing to win free attendance at the 2009 Annual Conference to be held on October 1, 2009; two registrants from the winning organization will be eligible to attend. The winning organization will be announced on February 28, 2009.

The primary member at your organization should complete the application form below and mail a check for the membership dues to:

Chicagoland Compliance Association, Inc
PO Box 06206
Chicago, IL 60606-0206

In order to keep costs at a reasonable level, invitations to all events are sent via email. Email changes or additional registrations may be made online throughout the year

On behalf of the Board of Directors, we thank all of our members for their continued support of the CCA. For new members in 2009, we welcome you to the CCA and look forward to meeting you at a future event. As always, your feedback is critical to the continued success of the CCA.

In spite of these uncertain times, we are certain that you will derive many benefits from membership in CCA. If you have any questions or would like additional information, please contact us at email or contact any of the Board Members listed below through our website at www.chicagolandcompliance.org.

Sincerely,

The Board of Directors of the Chicagoland Compliance Association

* Members save $25 for breakfast meetings and $100 for the annual conference

Membership Application

Organization Name:
Organization Website:
Type of Organization:		Financial Institution, Assets Less than $1 Billion: $60
		Financial Institution, Assets Greater or Equal to $1 Billion: $100
		Non-Financial Institution (i.e. Vendor): $100
Asset Size of Financial Institution:
Number of Branches:
Primary Regulatory Agency:		FDIC / State
		FRB / State
		OCC
		OTS
		NCUA
		N/A
		Other:



Primary Member Name:
Title/Position:
Certification/Designation (ie. CRCM, CRP, CPA):
Address:
City:
State:
Zip:
Phone:
Fax:
Email:
Compliance Area of Specialty (i.e. Deposits, Loans, CRA, Credit Card, BSA, OFAC, AML, NDIP, SEC, Fiduciary, Security, Operations, Reg O / SOX, Information Security, Data Integrity, Audit, Training, Consulting, Loan Review):

You agree to receive all CCA Event Notifications via e-mail only. You agree to have the information that you have provided on this form included in the electronic CCA Directory, unless you mark this box:



Additional Member Name:
Title/Position:
Certification/Designation (ie. CRCM, CRP, CPA):
Address:
City:
State:
Zip:
Phone:
Fax:
Email:
Compliance Area of Specialty (i.e. Deposits, Loans, CRA, Credit Card, BSA, OFAC, AML, NDIP, SEC, Fiduciary, Security, Operations, Reg O / SOX, Information Security, Data Integrity, Audit, Training, Consulting, Loan Review):

You agree to receive all CCA Event Notifications via e-mail only. You agree to have the information that you have provided on this form included in the electronic CCA Directory, unless you mark this box:



Additional Member Name:
Title/Position:
Certification/Designation (ie. CRCM, CRP, CPA):
Address:
City:
State:
Zip:
Phone:
Fax:
Email:
Compliance Area of Specialty (i.e. Deposits, Loans, CRA, Credit Card, BSA, OFAC, AML, NDIP, SEC, Fiduciary, Security, Operations, Reg O / SOX, Information Security, Data Integrity, Audit, Training, Consulting, Loan Review):

You agree to receive all CCA Event Notifications via e-mail only. You agree to have the information that you have provided on this form included in the electronic CCA Directory, unless you mark this box:



Additional Member Name:
Title/Position:
Certification/Designation (ie. CRCM, CRP, CPA):
Address:
City:
State:
Zip:
Phone:
Fax:
Email:
Compliance Area of Specialty (i.e. Deposits, Loans, CRA, Credit Card, BSA, OFAC, AML, NDIP, SEC, Fiduciary, Security, Operations, Reg O / SOX, Information Security, Data Integrity, Audit, Training, Consulting, Loan Review):

You agree to receive all CCA Event Notifications via e-mail only. You agree to have the information that you have provided on this form included in the electronic CCA Directory, unless you mark this box:



Additional Member Name:
Title/Position:
Certification/Designation (ie. CRCM, CRP, CPA):
Address:
City:
State:
Zip:
Phone:
Fax:
Email:
Compliance Area of Specialty (i.e. Deposits, Loans, CRA, Credit Card, BSA, OFAC, AML, NDIP, SEC, Fiduciary, Security, Operations, Reg O / SOX, Information Security, Data Integrity, Audit, Training, Consulting, Loan Review):

You agree to receive all CCA Event Notifications via e-mail only. You agree to have the information that you have provided on this form included in the electronic CCA Directory, unless you mark this box:



Additional Member Name:
Title/Position:
Certification/Designation (ie. CRCM, CRP, CPA):
Address:
City:
State:
Zip:
Phone:
Fax:
Email:
Compliance Area of Specialty (i.e. Deposits, Loans, CRA, Credit Card, BSA, OFAC, AML, NDIP, SEC, Fiduciary, Security, Operations, Reg O / SOX, Information Security, Data Integrity, Audit, Training, Consulting, Loan Review):

You agree to receive all CCA Event Notifications via e-mail only. You agree to have the information that you have provided on this form included in the electronic CCA Directory, unless you mark this box:



Additional Member Name:
Title/Position:
Certification/Designation (ie. CRCM, CRP, CPA):
Address:
City:
State:
Zip:
Phone:
Fax:
Email:
Compliance Area of Specialty (i.e. Deposits, Loans, CRA, Credit Card, BSA, OFAC, AML, NDIP, SEC, Fiduciary, Security, Operations, Reg O / SOX, Information Security, Data Integrity, Audit, Training, Consulting, Loan Review):

You agree to receive all CCA Event Notifications via e-mail only. You agree to have the information that you have provided on this form included in the electronic CCA Directory, unless you mark this box:



Additional Member Name:
Title/Position:
Certification/Designation (ie. CRCM, CRP, CPA):
Address:
City:
State:
Zip:
Phone:
Fax:
Email:
Compliance Area of Specialty (i.e. Deposits, Loans, CRA, Credit Card, BSA, OFAC, AML, NDIP, SEC, Fiduciary, Security, Operations, Reg O / SOX, Information Security, Data Integrity, Audit, Training, Consulting, Loan Review):

You agree to receive all CCA Event Notifications via e-mail only. You agree to have the information that you have provided on this form included in the electronic CCA Directory, unless you mark this box:



Additional Member Name:
Title/Position:
Certification/Designation (ie. CRCM, CRP, CPA):
Address:
City:
State:
Zip:
Phone:
Fax:
Email:
Compliance Area of Specialty (i.e. Deposits, Loans, CRA, Credit Card, BSA, OFAC, AML, NDIP, SEC, Fiduciary, Security, Operations, Reg O / SOX, Information Security, Data Integrity, Audit, Training, Consulting, Loan Review):

You agree to receive all CCA Event Notifications via e-mail only. You agree to have the information that you have provided on this form included in the electronic CCA Directory, unless you mark this box:



Additional Member Name:
Title/Position:
Certification/Designation (ie. CRCM, CRP, CPA):
Address:
City:
State:
Zip:
Phone:
Fax:
Email:
Compliance Area of Specialty (i.e. Deposits, Loans, CRA, Credit Card, BSA, OFAC, AML, NDIP, SEC, Fiduciary, Security, Operations, Reg O / SOX, Information Security, Data Integrity, Audit, Training, Consulting, Loan Review):

You agree to receive all CCA Event Notifications via e-mail only. You agree to have the information that you have provided on this form included in the electronic CCA Directory, unless you mark this box: