ASWA Membership Application

ASWA Membership Application

American Society of Women Accountants
National Headquarters
8405 Greensboro Drive, #800, McLean, VA 22102
Phone: 703-506-3265 Fax: 703-506-3266 E-mail: aswa@aswa.org

Member # _______________

Chicago Chapter 2005-2006 Dues:

	Regular Member ($141) Hold a CPA certificate or equivalent; two or more years experience in accounting; Bachelor's degree
	Affiliate Member ($141) Not actively engaged in accounting; have a substantial interest in accounting
	Student/Associate Member ($64) Regularly enrolled student; less than two years experience in accounting

Please check your preferred mailing address:

Residence Address Business Address

_____________________________________________ _____________________________________________

Last Name First Name Firm Name

_____________________________________________ _____________________________________________

Address Firm Address

_____________________________________________ _____________________________________________

City State Zip City State Zip

_____________________________________________ _____________________________________________

Phone Fax Phone Fax

_____________________________________________ _____________________________________________

Email Email

Estimated Date of Graduation (if in School) ________________ OR, Date Degree Received___________________

Date _________________ Name of School_____________________________ Major ____________________

Certifications: CPA CMA CIA CA CFP CISA EA Other______________________________

For CPA, State of Certification __________________________________ DATE ___________________________

Field of Accounting: Academia Government Industry Non-Profit Private Public

Job Classification: Audit-Internal    Audit-External    Budget/Planning    Consulting    Cost Accounting

Financial Analysis   General Accounting   Management Accounting   Sole Practitioner

Systems Accounting     Tax     Other

Payment by: VISA M/C My check is enclosed.
Card Number______________________ Exp. Date __________ Signature_____________________________________

________________________________________      ________________________________________________________

Applicants Signature Sponsor's Signature Sponsor's Member ID

Chapter Verification: (Applicant will not be considered paid in full unless BOTH National and Chapter dues are received.)
CHAPTER NAME __Chicago______________________  CHAPTER NO. _____2_____  DATE____________________
CHAPTER REPRESENTATIVE'S SIGNATURE____________________________________________________

ASWA dues are deductible as business expense, but not as charitable contribution for federal tax purposes.
National Dues include $35 for a year's subscription to: The Edge.