Royal Sonesta Hotel

New Orleans, LA

- I would be delighted to attend the ASCPA Student Education Fund Breakfast. Please accept my payment of Contribution - $100 Contribution - $50 per person for (number) attending.

- I am unable to attend. Please accept my donation to the Student Education Scholarship Fund in the amount of $

Name:
Guest(s) Name:
Company:
Street Address:
City:
State:
Zip Code:
Telephone:
FAX:
E-mail:

All contributions to the ASCPA Student Education Fund are tax deductible in accordance with IRS section 501(c)3.

			Payment Method:
	
	Mailing Company Check
	
	Mailing Personal Check
	
	Visa
	
	Mastercard 
	
	AMEX        

	

	Credit Card #:      

	

	Expiration Date:      

	

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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.