Wisconsin Association of Accountants Application

Application for Membership

MEMBERSHIP DUES:

• Active Dues - $125/yr
  Associate Dues - $90/yr
  Retired Dues - $25/yr.
• First year only membership pricing is Active Dues - $99/yr and Associate Dues - $70/yr.
• The dues year is July 1 through June 30.
• Dues are prorated on a monthly basis for the first year. Once your application is approved, you will be billed the appropriate amount of dues based on member type and month joined.

Please fill in the information below and click the "Submit" button to submit this form to us.

Membership Type: Active Associate Retired Student **Membership Type Explanation

Applicant Business Contact Information:

First Name: Last Name:
Accreditations:
Name of Firm:
Street: City:
State: WI IA MN MI IL Zip Code: County:
Business Phone:
Non Business Phone: Email:
Applicant Type: Sole Practitioner Partner Employee Corporate Officer None of the Above

Applicant Professional and Background Information

Years of Experience in Accounting:
Years in Public Practice:
United States Citizen? yes no
Certified Public Accountant? yes no
Enrolled to Practice before the IRS? yes no
Member of NSA? yes no
Accredited by the Accreditation Council in Accounting? yes no
Accredited by the Accreditation Council in Taxation? yes no
PTIN (is only required to report your CPE to IRS)
Degrees:

Schools Attended:

Describe Practical Experience:

What prompted your interest in this Association and why would you like to join?


Do you operate your practice on a full time basis? yes no

Practice Info (%):
   Write Up:
   Tax Prep:
   Management Consulting:
   Other:
Are you engaged in any other employment or occupation? yes no
Full time? yes no
Have you ever been convicted of an offense other than traffic violation? no yes
Member Sponsor: