Membership Type

Annual Membership Dues

Individual/Retired Membership
     CPA Exam Passed (mo.yr) ________________
     CPA Certification (mo/yr) ________________
     Certificate Number/State ________________
 
Student Member
    Expected CPA Exam (mo/yr) _____________ 
Annual National Membership Dues
     Individual Member (CPA)                                       $145
     Retired Member                                                      $60             
     Student Member                                                     $30
 
Annual Tampa Affiliate Dues
   Individual/Retired                                                     $25
   Student                                                                       $12.50

Applicant Information

Payment Information

Name ________________________________________________
 
Title __________________________________________________
 
Company ____________________________________________
 
Phone _______________________________________________
 
Email ________________________________________________
Credit Card Number _______________________________________
 
Expiration Date __________________       CSV _________________
 
Zip Code ___________________________________________________
 
Make checks payable to:
   AWSCPA
   4056 Tampa Road, Oldsmar, Florida 34677