Membership Application

Member Classification

Have you previously been a member of the UACPA?

NoYes

I am applying for membership as *

Member-Fellow - Members living in Utah that are currently licensed or have passed the Uniform CPA exam at one point.
Member-Non-Resident - Members residing outside the state of Utah or the country. Must be currently licensed as a CPA in any state OR have passed the Uniform CPA exam at one point.
Member-Retired - Retired CPA (55 years or older, gainfully employed less than 15 hours per week). May not be affiliated with a firm or employer.
Non-CPA Professional Affiliate - Must possess a BA or above, be willing to sign a statement that they will abide by the Code of Conduct and Professional Ethics as appropriate, and be sponsored by two full UACPA members. Sponsorship page and Code of Conduct Statement. This category includes non-CPA professionals actively employed in public accounting; non-CPA professionals employed in industry, government or education actively working in management, finance, accounting, economics or technology; and licensed attorneys.
Non-Resident Non-CPA Affiliate - Individuals residing outside the state of Utah or the country. Must possess a BA or above, be willing to sign a statement that they will abide by the Code of Conduct and Professional Ethics as appropriate, and be sponsored by two full UACPA members.Sponsorship page and Code of Conduct Statement. This category includes non-CPA professionals actively employed in public accounting; non-CPA professionals employed in industry, government or education actively working in management, finance, accounting, economics or technology; and licensed attorneys.
Student Affiliate - Must be enrolled in a college or university with an interest in accounting or business. Dues are FREE!
Trial Membership - As a trial member, your profile information will not be listed in print or online versions of the UACPA Resource & Membership Directory. Promo code and applicable Ethics Exam purchase required.

General Information

First name or initial *

Middle name or initial

Last name *

Suffix (Sr., III, etc.)

Other credentials (MBA, Ph.D., etc.)
Nickname

Date of birth (mm/dd/yyyy)

Spouse

Gender *	MaleFemale

Ethnic origin

Home Information

Address

P.O. Box (or street cont.)

City

State
ZIP code

Foreign address **
If not living in the U.S.A., choose foreign address from state drop down, and enter province, country, postal code in the Foreign Address box.

Contact Information

Home phone * (xxx-xxx-xxxx)

Mobile phone (xxx-xxx-xxxx)

Fax (xxx-xxx-xxxx)

Preferred e-mail *

Send Non-CPE mail to my *	HomeOffice
Send CPE mail to my *	HomeOffice

UACPA Chapter Preference

Please select your UACPA chapter preference
Preferred chapter *

Terms and Conditions

I have read the terms and conditions

To the best of my knowledge and belief, the information contained herein is true and correct. By completing this application, I hereby represent to the UACPA that I will be bound by the Association Bylaws and Code of Professional Conduct.

Join the UACPA

ConnectWithUs

Membership Application

Member Classification

I am applying for membership as *

General Information

First name or initial *

Middle name or initial

Last name *

Suffix (Sr., III, etc.)

Other credentials
(MBA, Ph.D., etc.)

Nickname

Date of birth
(mm/dd/yyyy)

Spouse

Gender *

Ethnic origin

Home Information

Address

P.O. Box (or street cont.)

City

State

ZIP code

Foreign address **

Contact Information

Home phone *
(xxx-xxx-xxxx)

Mobile phone
(xxx-xxx-xxxx)

Fax
(xxx-xxx-xxxx)

Preferred e-mail *

Send Non-CPE mail to my *

Send CPE mail to my *

UACPA Chapter Preference

Preferred chapter *

Terms and Conditions

Join the UACPA

ConnectWithUs

Membership Application

Member Classification

I am applying for membership as *

General Information

First name or initial *

Middle name or initial

Last name *

Suffix (Sr., III, etc.)

Other credentials (MBA, Ph.D., etc.)

Nickname

Date of birth (mm/dd/yyyy)

Spouse

Gender *

Ethnic origin

Home Information

Address

P.O. Box (or street cont.)

City

State

ZIP code

Foreign address **

Contact Information

Home phone * (xxx-xxx-xxxx)

Mobile phone (xxx-xxx-xxxx)

Fax (xxx-xxx-xxxx)

Preferred e-mail *

Send Non-CPE mail to my *

Send CPE mail to my *

UACPA Chapter Preference

Preferred chapter *

Terms and Conditions

Other credentials
(MBA, Ph.D., etc.)

Date of birth
(mm/dd/yyyy)

Home phone *
(xxx-xxx-xxxx)

Mobile phone
(xxx-xxx-xxxx)

Fax
(xxx-xxx-xxxx)