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First name
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Accreditation
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Company
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e-Mail
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Phone Number
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Address 2
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State/Province
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Mailing Country
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Nick Name
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PTIN (Tax Preparer ID)
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Website
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Practice Type- Check all that apply
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Accounting
Bookkeeping
Financial Advisor
Tax Preparer
Corporation
Partnership
Sole Practitioner
LLC
LLP
Other
Areas of Practice
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Tax Services
Audits & Reviews (CPA)
Bookkeeping
Client Write-Up
Compilations & Reviews (Non-CPA)
Corporations/Partnerships
Estate Planning
Estates & Trusts - Taxation/Administration
General Accounting
Government Accounting
IRS Representation
International Taxation
Non-Profits
Notary
Payroll
Directory listing text
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Referral
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Home Address
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Home Suite/Unit/Apt
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Home City
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Home State
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Home Zip
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Home Phone
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Cell Number
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Your Age
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under 25
25-40
41-55
56-75
76 or older
Years of Experience
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Under 8 (Rising Star)
9-20
21-35
36 or more
Your role in the Practice
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Sole Practitioner
Partner
Principal
Employee
Other
Are you an Electronic Return Originator?
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Yes
No
If an ERO, provide the year designated
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Other Organizations I Belong To
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NONE
AICPA
ASTPS
NAEA
NATP
NSA
NSTP
VASEA
VSCPA
Other
How Did You Hear About ASV/VSTAP
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Internet Search (Google, bing, etc)
Social Media (Facebook, Twitter, LinkedIn)
Direct Mail (mailing, postcard)
Electronic mail (email, newsletter)
Word of Mouth (Friend/Coworker)
Professional accounting Group (NSA, NASBA)
Employer
Member Referral
Returning Lapsed Member
Other (please describe)
Other
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Passed RTRP
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Yes
No
Confirmation of eligibility - Active Member
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I am permitted/licensed to practice under state law
I am accredited by ACAT in Accountancy/Tax Preparation/Tax Advising
I am enrolled to practice before the IRS (EA)
I have an AS, BS or higher degree w/ 24+ hours in accountancy
I have 3+ years experience in Accounting/Tax
Supplemental info to Confirmation (Active)
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Confirmation of eligibility - Associate Member
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Owner/Partner/Employee of tax firm and DO NOT MEET Active member criteria
Employed in gov't, financial institution, private sector or non-profit
I am 65+ yrs of age and retired from public practice
Confirmation of eligibility - Student Member
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Committees & Volunteerism
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Advisory / Mutual Assistance Program
Annual Convention
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©2019, Virginia Society of Tax & Accounting Professionals, f
ormerly The Accountants Society of Virginia,
is a 501(c)6 non-profit organization.
PO Box 651284 | Potomac Falls, VA 20165-1284 | Phone: (800) 927-2731 | Fax:
(888) 403-0920 |
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