| Name * |
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| E-mail Address * |
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| Highest Degree Earned |
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| College Degrees Earned |
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| Professional Credentials |
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| Professional Association Memberships |
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| Tax Industry Experience |
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| Professional Activities |
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| Business Name * |
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| Address * |
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| City * |
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| Zip Code * |
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| State * |
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| Phone Number * |
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| Fax Number |
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| Website URL |
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| Your Role in the Business (Examples: Owner, President, CEO, Manager, etc.) |
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| What services does your business offer? (Examples: Tax preparation, taxpayer representation, tax school, tax refund bank products, tax planning, financial planning, bookkeeping, payroll, business accounting, other.) |
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| How many offices do you have? |
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| What percentage of your annual revenue is derived from tax preparation? (Include revenue from all related services and/or products) * |
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| What interested you in NATBO? How did you hear about NATBO? |
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| Are you willing to serve on a volunteer committee if invited by the NATBO Board? * |
Yes
No
Maybe
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| If Yes (or Maybe), please indicate your area(s) of interest |
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| Please provide the names and contact information for any other qualified candidates for membership in NATBO |
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| Please select which NATBO membership option you wish to apply for * |
Regular (voting) Membership
Associate Membership
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