Society of Louisiana
Certified Public Accountants

2400 Veterans Blvd.,
Suite 500
Kenner, LA 70062
(504) 464-1040
1-800-288-5272

LCPA New Member /Reinstatement Application

Upon approval, new members will be e-mailed a New Member Kit containing details on LCPA's outstanding member services and discounts. Reinstated members will receive a confirmation e-mail.

Membership in the Society is your first step in achieving your personal and professional goals.

Thank you for joining!


How did you learn about the LCPA?

Name:
Mr. Mrs. Ms.

Home Address:

City/State/Zip:

Contact phone number :

E-mail address :

Birth Date:

Employer:

Employer Address:

City/State/Zip:

LA CPA License Number


Credit Card Information





Credit Card No.

Expiration Date:

CVS#

Cardholder's Name as Printed on Card:

Billing Address of Card:

City/State Zip:

Amount:


Do you maintain your CPA license?
Yes No

Have you ever been a member of the LCPA?
Yes No

Do you wish to receive Society notices via your business fax number?
Yes No

Do you wish to receive Society notices via your e-mail address?
Yes No

Are you a member of the AICPA ?
Yes No

AICPA Member Number

Select Your Dues Classification

The following dues categories are based on the position you hold in the business world. Please select the single dues category which applies to your current position. The category you choose should be reflective of your title within your organization, whether accounting or non-accounting related. If you do not indicate a category, you automatically will be assigned the "Other" dues category.

Retired Full-time *
Out-of-State Member
Candidate Member **
Owner
Sole Practitioner
Partner/Shareholder
Attorney/Lawyer
Chief Executive Officer (CEO)
Chief Financial Officer (CFO)
Chief Administrative Officer (CAO)
Controller
Dean
Department Head
Professor
Instructor
Officer (President, Vice President, etc.)
Manager
Administrator
Public Accounting Firm Staff
Non-Public Accounting Firm Staff***
Other


2009-10 ANNUAL DUES SCHEDULE

Annual Dues are billed each May 1 and are based on the following schedule adopted by the LCPA's Board of Directors on February 19, 2009.

Retired Full-Time Member (as described in Membership Qualifications) $85.00
Out-of-State Member  $120.00
Candidate Member** $140.00
Owner (of any business) $230.00
Sole Practitioner $230.00
Partner/Shareholder $230.00
Attorney/Lawyer $230.00
Chief Executive Officer $210.00
Chief Financial Officer $210.00
Chief Administrative Officer $210.00
Controller $210.00
Dean $210.00
Department Head $210.00
Professor $210.00
Instructor $210.00
Officer (President, VP, etc.) $210.00
Manager $210.00
Administrator $210.00
Public Accounting Firm Staff $210.00
Non-Public Accounting Firm Staff*** $180.00
Other $210.00
Family & Employment Leave*** $120.00

* A member must be retired full time from active status in any profession or business, whether or not related to an accounting function. The reduction in dues shall cease when the member resumes active full-time or part-time status.

** Candidate Members have passed the Uniform CPA Exam after 6/18/99 and are working toward meeting the experience requirement for licensure.

*** Non-Public Accounting Firm Staff includes industry, government & education staff members.

**** Family & Employment Leave: Members on family or employment leave from their professional position in excess of six months may pay reduced dues of $120 until the member resumes active status. This option is subject to annual renewal.

NOTE: Contributions or gifts to LCPA are not deductible as charitable contributions for federal income tax purposes. However, dues may be deductible as ordinary and necessary business expenses.

I hereby certify that the information contained herein is true to the best of my knowledge and belief; that I have never been convicted of a felony or any criminal charge arising out of the practice of my profession; that my certification or licensure has never been suspended or revoked by any state; and that I have never been suspended or expelled from any professional organization. If admitted to membership, I agree to be governed by and comply with the Charter and Bylaws of the Society of Louisiana Certified Public Accountants.

Society of Louisiana Certified Public Accountants | 2400 Veterans Blvd., Suite 500 • Kenner, LA 70062 | (504) 464-1040 • 1-800-288-5272
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