Florida Society of Accountants - Membership Application

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Membership Application

Membership Application:

First Name:
Last Name:
Address:
City:
State:
Zip:
Phone:
Fax:
Email Address:

PERSON APPLYING FOR PROFESSIONAL REGULAR MEMBERSHIP MUST MEET ONE OF THE FOLLOWING REQUIREMENTS.

Check All That Apply:

ACCREDITED BY THE ACCREDITATION COUNCIL OF ACCOUNTING AND TAXATION, INC.

ACCOUNTING (ABA) & TAXATION (ATA) TAXATION (ATP)

-OR-

ENROLLED AGENT

ENROLLMENT NUMBER:

-OR-

CERTIFIED PUBLIC ACCOUNTANT

STATE LICENSE NUMBER:

-OR-

AN ACCOUNTANT, TAX PRACTITIONER, OR BOOKKEEPER WHO HAS NOT LESS THEN TWO YEARS EXPERIENCE IN PUBLIC PRACTICE.

PERSON NOT MEETING PROFESSIONAL REGULAR MEMBERSHIP QUALIFICATIONS ABOVE MAY APPLY FOR ASSOCIATE, STUDENT, EDUCATOR, NON-RESIDENT, OR RETIRED MEMBERSHIP. CHECK THE STATEMENT BELOW THAT BEST APPLIES TO YOU:

PROFESSIONAL ASSOCIATE MEMBER. BUSINESS PROFESSIONALS IN RELATED FIELDS OF ENDEAVOR OR THOSE PROFESSIONALS THAT DO NOT QUALIFY AS PROFESSIONAL REGULAR MEMBERS

ASSOCIATE MEMBER. A BUSINESS PROFESSIONAL EMPLOYED IN BUSINESS, INDUSTRY OR GOVERNMENT THAT DO NOT OFFER THEIR SERVICES TO THE GENERAL PUBLIC

STAFF ASSOCIATE MEMBER. STAFF MEMBERS OF PROFESSIONAL REGULAR MEMBERS, PROFESSIONAL ASSOCIATE MEMBERS OR ASSOCIATE MEMBERS.

EDUCATION MEMBER. FACULTY AND ADMINISTRATOR OF STATE APPROVED COLLEGES, UNIVERSITIES, COMMUNITY COLLEGES OR BUSINESS SCHOOLS.

NON-RESIDENT MEMBERS. ANY PERSON RESIDING IN ANOTHER STATE THAT WOULD OTHERWISE QUALIFY AS A PROFESSIONAL REGULAR MEMBER.

RETIRED MEMBER. AN FSATP, NSA, OR ASO MEMBER WHO HAS RETIRED FROM PUBLIC PRACTICE.

STUDENT MEMBER. AN ACCOUNTING, TAX, OR BUSINESS STUDENT ENROLLED IN A FULL OR PART TIME PROGRAM LEADING TO A DEGREE CERTIFICATE.

I hereby state that the statements made in this application are correct. I further state that I will abide by the Articles of Incorporation and the By-Laws of the Society and will practice in strict conformity with the Code of Ethics and Rules of Professional Conduct as adopted by the Society.

DUES AND PAYMENTS

Professional Regular.....$100.00	Professional Associate.....$75.00	Associate................$75.00
Staff Associate..................$15.00	Educator.............................$15.00	Non-Resident.........$10.00
Retired...............................$25.00	Student...............................$15.00

*Initiation Fee - add $25.00
	Dues:	$_____.00

	Initiation Fee:	$25.00

	Total Remitted:	$_____.00

Please Mail Your Check To:

FLORIDA SOCIETY OF ACCOUNTANTS
PO BOX 156
New Port Richey, FL 34656

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