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Home Join / RenewMembership Reinstatement Application

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Home Join / Renew Membership Reinstatement Application

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Your Membership is MoreValuable Than Ever

Your Membership is More
Valuable Than Ever

Ready to return? There’s no better time to rejoin the Academy. Reconnect with exclusive resources, thought leadership, and the community that supports your continued success.

Fill out the form below to submit your reinstatement application.

Reinstatement Application Form

"*" indicates required fields

Step 1 of 4

25%

Are you currently, and have you been living in the United States for the last three years?*

Yes

No

Are you currently, and have you been working in the United States for the last three years?*

Yes

No

Has any actuarial organization ever taken disciplinary action (i.e., reprimand, suspension, or expulsion) against you?*

Yes

No

Have you been convicted of a felony?

Yes

No

Name*

First Last Suffix

Date of Birth*

MM slash DD slash YYYY

Gender*

Male

Female

Prefer not to say

Employer*

Title*

Business Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Business Phone*

Business Fax

Work Email*

Home Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Personal Phone

Personal Fax

Personal Email

Have you been a resident of the United States for more than three years?*

Yes

No

If no, please provide a separate statement, on your letterhead, indicating the need for your association with the Academy and familiarity with U.S. practices.*

Attach Separate Statement if Needed

Send mail to:*

Business

Home

Your Background

Membership Education Requirements

American Society of Pension Professionals and Actuaries

Casualty Actuarial Society

Conference of Consulting Actuaries

Society of Actuaries

Other

Status in other actuarial organizations (current membership isn’t required)

American Society of Pension Professionals and Actuaries Level*

Date Attained*

MM slash DD slash YYYY

Casualty Actuarial Society Level*

Date Attained*

MM slash DD slash YYYY

Conference of Consulting Actuaries Level*

Date Attained*

MM slash DD slash YYYY

Society of Actuaries Level*

Date Attained*

MM slash DD slash YYYY

Please specify the name of the organization*

Level Attained*

Date Attained*

MM slash DD slash YYYY

Are you an enrolled actuary?*

Yes

No

Enrollment Date*

MM slash DD slash YYYY

Enrollment Number*

Has any actuarial organization ever taken disciplinary action (i.e., reprimand, suspension, or expulsion) against you?*

Yes

No

If yes, please explain.*

Date your Academy membership ended:*

MM slash DD slash YYYY

Why do you want to renew your membership?

Please submit the name and contact information of a member of the American Academy of Actuaries or another actuary who is subject to the Code of Professional Conduct who can detail and confirm your work and knowledge of applicable U.S. laws and practices.

Reference Name*

First Last

Reference Organization*

Reference Title*

Reference Email*

Reference Phone*

Reference Actuarial Designations*

Describe your actuarial experience in detail.

Name of Current Employer

Name and Position of Immediate Supervisor

Duties, and Actuarial Responsibilities

Start Date (month/year)

End Date (month/year)

Years and Months of Actuarial Experience

Have you ever been convicted of a felony?*

Yes

No

If yes, describe the facts and circumstances of the conviction on a separate piece of paper and return it with this application. A conviction does not automatically preclude you from membership in the Academy, but will be considered (with your explanation) as part of the reinstatement process.*

Application Statement:

U.S. Knowledge Attestation:*

I attest to necessary knowledge of U.S. laws and practices in my area(s) of actuarial practice with due consideration given to Precept 1 of the Code of Professional Conduct.

Reference Acknowledgment:*

I understand that an Academy representative may contact the individual (member of the American Academy of Actuaries or another actuary who is subject to the Code of Professional Conduct who can detail and confirm the applicant’s work and knowledge of applicable U.S. laws and practices) I listed on this membership application.

Professionalism Attestation:*

I attest that I have reviewed Professionalism for U.S. Actuaries, Outline of Concepts and Structure (as of October 2021) and the following related documents and I believe that I have a reasonable understanding of the items listed below:

Code of Professional Conduct

Qualification Standards

The following documents related to Actuarial Standards of Practice (ASOP):

ASOPs Nos. 1, 21, 23, and 41, and
The Applicability Guidelines for my area(s) of actuarial practice; and

Articles IX and X of the Academy’s By-Laws (relating to member discipline and the role of the ABCD)

Consent*

If my application is accepted, I agree to be bound by the Academy Bylaws, Code of Professional Conduct, the Qualification Standards for Actuaries Issuing Statements of Actuarial Opinion in the United States, and by the Actuarial Standards of Practice of the Actuarial Standards Board.

Certification*

I certify that the information provided for this application is, to the best of my knowledge, accurate and truthful.

Your Full Name*

Today's Date*

MM slash DD slash YYYY

If you are approved for reinstatement, you will receive an invoice for annual dues.

Comments

This field is for validation purposes and should be left unchanged.

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