Arkansas Society of CPAs

Student Education Fund Breakfast

Friday, September 19, at 7:30 a.m.

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 CheckMailing Personal CheckVisaMastercard
	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.