Membership Renewal Form

CPA Firm Management Association is a firm-based membership association that offers maximum benefit to members at minimal cost with a membership plan designed for your specific needs.

Firm / Company Information

Firm/Company

Address

Country

Phone

Fax

Website

Firm size (number of personnel):

Number of Offices:

Local Chapter Affiliation:

Primary Contact (individual responsible for management/administration) *Required

Full Name

Nickname

Designations

Direct Dial Number

Secondary Contact (designated partner or shareholder) *Required and included in membership fee

Please check this box if you are a sole proprietor, solo practitioner or your firm chooses to not include a secondary contact.
Note this secondary contact is included with the membership fee and carries no additional fee.

Full Name

Nickname

Designations

Direct Dial Number

Connections (additional individuals from the firm) *Additional membership fee required

First Connection Information:

Full Name

Nickname

Designations

Direct Dial Number

Second Connection Information:

Full Name

Nickname

Designations

Direct Dial Number

Third Connection Information:

Full Name

Nickname

Designations

Direct Dial Number

Billing Information Same as above

Firm/Company

Address

Country

Phone

Payment Information

Membership Categories and Dues (Check all that apply)

Firm Member (includes individual responsible for the management of the firm and a designated partner/shareholder) $395/year

First Connection (additional individual from the member firm - please enter their information above) $99/year

Second Connection (additional individual from the member firm - please enter their information above) $99/year

Third Connection (additional individual from the member firm - please enter their information above) $99/year

Consultant Special Interest Group (Consultant SIG) (applicant serves as a consultant to the accounting profession) $395/year

Vendor Special Interest Group (Vendor SIG) (applicant provides products and/or services to CPAFMA members and firms) $395/year

BDO Alliance Member Firm Membership $370/year

Total to Charge

Payment Method

Visa

Mastercard

American Express

Invoice Me

Card Number

Expiration Date

CVV2 Code:

(3 or 4 digit code on back of card)

Cardholder's Name