* Required Fields

Personal Information

* First Name:
MI:
* Last Name:
Gender:
Date of Birth:
(As you would like it to appear on your SDCPAS membership certificate and on your SDCPAS record)
Nickname:
Maiden Name:
Spouse:

Home Contact Information

* Street Address:

select
P. O. Box:

select
* City:
* State:
select
* Zip Code:

select

Professional Contact Information

Position / Title:


Name of Business / Firm:
Business Web Site:


Mail-Stop:
Street Address:

select
P. O. Box:

select
City:
State:
select
Zip Code:
Direct Fax:
Ext:
Direct Phone:

Contact Preferences

Preferred address for SDCPAS mailings:
Preferred address for CPE mailings:
Include my information in the online SDCPAS membership directory (members only access):
May we send you faxes?
May we send you emails?
* Preferred Email: * Afterhours/Emergency Phone Number:

Education and Certifications

College/University:
Year Graduated:
Degree:
Advanced Degrees / Professional Credentials:

If you are certified, please provide the following information from your original CPA certificate:

Original Certificate Number:
Issued by the State of:
Date Issued:

If you hold an South Dakota reciprocal CPA certificate, please provide the following information:

Reciprocal Certificate Number:
Date Issued:
If you are a member of AICPA, please provide your AICPA Member Number:

If you are not a certified public accountant, please select from the following options that best applies to you:

Managerial Non-CPA working under the supervision of a CPA
Firm Administrator or Non-CPA working under the supervision of a CPA in public accounting
Non-CPA owner registered with the Board of Accountancy (BOA)
Name of CPA Supervisor:
Non-CPA educators teaching accounting at accredited post-secondary institutions
Name of School:

Employment

Please complete only one of the following three categories in this section.

Public Accounting

If employed in public accounting in excess of 50% of your time, please provide the following information:

Type of Firm:
select
Position:
select

Business, Industry, Education, or Government

If employed in business, industry, education, or government in excess of 50% of your time, please provide the following information:

Primary Areas of Service(s):
select
Principal Function:
select

If Not Employed, Please Check One of the Following

Primary Interests

This section is used to help identify your areas of interest so that we may provide you with information that is relevant. You may select up to seven areas of interest below.

select
select

select
select

select
select

select

Membership Requirements and Classes

Class Description Pro-Rated New Member Fee *
CEO/CFO/Owner $145.83
Educator $62.50
Firm Administrator $62.50
Government $62.50
Industry $100.00
Partner $145.83
Retired $62.50
Student $20.83
Sole Practitioner $145.83
Staff $100.00
Honorary $0.00
* Prorated fees are based on the number of months remaining in the membership year, which begins June 1st.
** A membership application fee of $20.00 will be added to the prorated fee.

Please Select a Payment Method



  Visa MasterCard Discover

  Check

Total Amount Due:

Credit Card Payment Details


* Cardholder's First and Last Names:
* Credit Card Type and Number:
select
* Expiration Date:
select
select
* Security Code:
* Street Address:
* ZIP Code / State:
select

To the best of my knowledge the information contained herein is accurate and I agree to be governed by the bylaws of the South Dakota CPA Society (SDCPAS).

Your membership will be processed upon receipt of this application and your payment. A confirmation notice and related items will be sent to you shortly afterwards.