L. S. I. A.SeminarsNSANewsletterQF/TB Forms/Misc.LSIA Business2010 LSIA Convention
LSIA NOW ALLOWS YOU TO REGISTER ONLINE!!!!

CLICK HERE TO PAY YOUR DUES ONLINE!!!!
Pay Annual Dues On-Line
Mailing address:
LSIA
P.O. Box 60055
Lafayette, LA 70596-0055

Active Member $100 (Licensed CPA, EA, ABA or possess an Assoc. or Bach. Degree with 24 hrs. in Acct)
Associate Member $100 (Employed as an accountant in govt., financial instituions, or private firms)
Student Associate Member $10
Educator Associate Member $25
Retired Member $25
Non-Resident Member $20

Note: Choose Member Type below in section with CPA, EA, etc.
FOR A PRINT-OUT PRINT BEFORE SUBMITTING THIS FORM.
EACH INDIVIDUAL MUST FILL OUT A SEPARATE DUES STATEMENT
 *Date Submitted:  
 *Name: First  
 *Last Name  
 *Mailing Address:  
 *City:  
 *State:  
 *Zip Code:  
 *Phone:  
Fax:  
E-Mail Address:  
Dues are for what year?  
 *Member Type and fees. Use drop down for fee schedule.  
Member Type: Please check all that apply.
 
  EA
 
  CPA
 
  ATA
 
  ABA
Other:  
Please check one:
Please check one:
Mail Check to: LSIA - P. O. Box 60055 - Lafayette, La. 70596-0055
 
  Check (payable to LSIA)
Or pay by credit card
 
  AM EX.
  Master Card
 
  VISA
Credit Card #: Space #'s according to card.  
CC Expiration Date: Month/Year  
 
  * Indicates required fields
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P.O. Box 60055Lafayette, LA 70596-0005(337) 993-9707(800) 847-6276Fax 888-224-8263