Registrant Information

First Name:
Last Name:
Certificate #:
Company:
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City:
State:
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Course Information

Course Title: Arkansas Technology Conference
Dates: November 3-4, 2008
Location: ASCPA Conference Center, 11300 Executive Center Dr, Little Rock, AR 72211

Are you a member of your State Society? Yes No
If yes, what State?:

Registration Fee: ASCPA Member - $405 Non-Member - $555
Payment Method: Mailing Company Check Mailing Personal Check Mastercard Visa AMEX
Credit Card #:
Expiration Date:
Cardholder Name

How to Register:

1) Print and fax this form, with MasterCard, Visa or American Express information, to 501-664-8320.

2) Or, you may mail this form, with a check, to Arkansas Society of CPAs, 11300 Executive Center Drive, Little Rock, AR 72211-4352.

3) Or, you may register by phone, with your MasterCard, Visa or American Express, by calling 501-664-8739 or 800-482-8739 (in Arkansas).

4) Or, you may submit this form via e-mail, by pressing the "submit" button below.

Please Note: Payment is required in order to reserve your registration in a class. Submitting this form without payment does not guarantee your registration. Mailed payments should be received 10 days prior to the course date, or the registration will be cancelled.