NEBRASKA SOCIETY OF
Certified Public Accountants
SERVING NEBRASKA AND ITS CPAS SINCE 1928
CPE REGISTRATION FORM
Firm Name Main Contact
Firm Address Email
City, State & Zip Phone
Confirmation:
Emailed
Mailed :
Address (if different than above)
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Course
Attendee
First & Last Name
Cost
Subtotal
0
*$15 Coupons are available to Society members to be used only once per year per NESCPA member.
Use $15 Coupon(s)
# of Coupons:
0
A $35 Late fee will be charged for registrations received by the Society less than 10 days prior to the event. Add Late Fee(s)
# of Late Fees:
0
Total Due
0
Comments / Special Accommodations:
Submit Registration and Pay Now via Credit Card or PayPal:
‐ OR ‐
Send registration information to the Society office and pay separately via check or credit card by mail, email or fax.
Payment will be:
Mailed
Faxed using the opens in new window Credit Card Payment Form.
Please remember that payment must be submitted separately to the Society office and be received within 5 days to confirm your registration.
Enter numbers shown:
635 S. 14TH ST. SUITE 330
LINCOLN, NE 68508
(402) 476-8482
(800) 642-6178
(402) 476-8731