State Committee Application

Complete this application to be considered for a member-at-large appointment to a state committee. Be specific and reply in as much detail as space permits. Applications are accepted from Feb. 1 to May 1 and appointments are finalized in July. 

Note: Chapter committee chairpersons have an automatic seat on corresponding state committee and do not need to apply. If you would like to be reappointed to a state committee, use our reappointment form.

Member ID: <populate-static>                Name: <populate-static>

Preferred Chapter: <populate-static>   E-mail: <populate-dynamic>

Gender:      Female        Male

Ethnicity:      African American        Asian         Caucasian        Hispanic     
                      Native-American         Other (please specify) 

Company: <dynamic>

General Business: <populate>             Specific Business: <populate>

Telephone: <populate>                           Fax: <populate>

Preferred Address: <populate>

General Position: <populate>

Specific Position: <populate>

Fields of Interest: <populate>
Please indicate only those areas in which you currently practice.

I would like to join the following state committees: (select no more than three)

Please list and rank your contributions to the state committee(s) on which you have served:

Please list and explain the goals and member services you think your preferred committees should address and how you will contribute.

California Board of Acountancy Service [If applicable, committee(s) and year(s) of service]:

AICPA Service [If applicable, committee(s), sub-committee(s) and year(s) of service]:

Service to other professional/community organizations and volunteer/elected public service experience–list most significant:

If appointed, I will make every attempt to attend all meetings and seek out assignments in order to enhance CalCPA activities and programs.

Date:      Signature: