The Georgia Society of Certified Public Accountants
GSCPA STUDENT MEMBERSHIP APPLICATION
APPLICANT INFORMATION Mr./Ms.
First
Middle Initial
Last
Date of Birth
q Male q Female
College or University
Faculty Advisor Name
Anticipated Date of Graduation
Referred By
CURRENT CONTACT INFORMATION Address
City
State
Zip
Cell Phone Number
Personal Email
Other Phone Number
School Email
May we contact you via text message? q Yes q No
PERMANENT CONTACT INFORMATION ( q Check if same as above) Address
City
State
Zip
Phone Number
PAYMENT INFORMATION Enclose your check for $25 payable to The Georgia Society of CPAs.
RETURN TO: The Georgia Society of CPAs, Six Concourse Parkway, Suite 800, Atlanta, GA 30328
Pay by credit card: q Visa
q MasterCard
q AmEx
q Discover
Card#
Exp. Date
Signature
Take the next logical step and join GSCPA!
If you have additional questions about The Georgia Society of CPAs student membership, please contact Callie Hammond at 404-504-2953 or chammond@gscpa.org.
join.gscpa.org
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