Date: Tue Mar 21 19:24:38 2023
First Name: Last Name:
Firm: Email:
Address:
City: State: Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Zip:
Work Phone: Fax: Alternate Phone:
Date of Birth:* Gender:* Race/Ethnicity:*
*This information is collected for demographic purposes only and will be kept confidential and anonymous and will only be used in the aggregate.
Licenses I am licensed in: Missouri Kansas Other:
Artistic Discipline Preference (if any):
Additional Participation:
I would be interested in: speaking at a KCVLAA seminar writing for KCVLAA publications serving on the board of directors of a small arts organization mentoring a student who is volunteering at KCVLAA
Acknowledgment to my employer:
Send my supervisor, a copy of the thank you letters acknowledging my volunteer service.
Colleagues who might also be interested in volunteering with KCVLAA:
Name: Email:
Fee-Generating Clients: KCVLAA maintains a roster of accountants who will take referrals from client who can pay. There is no fee to be on our volunteer roster! But if you would like your name added to the fee referral list, check the applicable boxes below and either enclose a check for the annual $25.00 referral list fee, or submit a KCVLAA Membership Form with the appropriate membership fee.
I am willing to consider reducing my fees in appropriate circumstances. I am interested in fee-generation clients. I am interested in volunteering.
Please send check to: KCVLAA, P.O. Box 413199, Kansas City, MO 64141-3199 KCVLAA is a Missouri 501(c)(3) Non-Profit Corporation
