Registrant Information

First Name:
Last Name:
Certificate #:
Company:
Street Address:
City:
State:
Zip Code:
Telephone:
Fax:
Email:
Website:
Are you a member of your State Society?
If yes, what State?
Are you a member of the American Institute of CPAs?

Course Information

Course 1  
  Course Title:
  Date(s):
  Location:
  Registration Fee: $
Course 2  
  Course Title:
  Date(s):
  Location:
  Registration Fee: $
Course 3  
  Course Title:
  Date(s):
  Location:
  Registration Fee: $
Subtotal: $

AICPA Discount:               

(Only if applicable -AICPA Members receive a $30 per course discount only on AICPA sponsored courses.)

 $
Total Registration Fees:     $
Payment Method:
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.

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Contact the Arkansas Society of CPAs at bangel@arcpa.org or 501-664-8739.
Send mail to ssubedi@arcpa.org with questions or comments about this web site.
Copyright © 2000 Arkansas Society of Certified Public Accountants
Last modified: April 25, 2008