Registrant Information

    First Name      : 
     Last Name      : 
 Spouse/Guest Name  : 
       Company      : 
Street Address      : 
          City      : 
         State      : 
      Zip Code      : 
     Telephone      : 
           FAX      : 
        E-mail      : 
          

Total # of Children 

Attending (Age 14 & Under): 

Name/Age

How to Register:

1) Print and fax this form, to 501-664-8320.

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

3) Or, you may register by phone 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.