1650 West 82nd Street, Ste 600
Bloomington MN 55431
Ph: 952-831-2707 Fax: 952-831-7875
www.mncpa.org
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Minnesota Society of Certified Public
Accountants 1650 West 82nd Street, Ste 600 Bloomington MN 55431 Ph: 952-831-2707 Fax: 952-831-7875 www.mncpa.org |
| Name: | ___________________________________________________________________ |
| ID#: | ______________ |
| Address: | ___________________________________________________________________ |
| City: | ___________________________________________________________________ |
| State: | ________ |
| Zip: | ______________________ |
| Phone: | ______________________________________ |
| Email: | ___________________________________________________________________ |
| Event Code | Description | Date | Fee | AICPA Disc. | Amount |
| Total: | |||||
Check # ________________
Please make checks payable to Minnesota Society of CPAs.
Bill me
Your event confirmation serves as the first invoice. Payment must be
received by the MNCPA prior to the event start date.
Credit card
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Card type: American Express Discover MasterCard Visa |
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Please indicate: Firm/company card Personal card |
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| Account # | _____________________________________________________ |
| Exp. date: | _____________________ |
| Signature | _________________________________________________ |
| Date: | _______________________ |