Membership Application

The National Society of Accountants for Cooperatives (NSAC) is a professional society that offers maximum benefit to members at minimal cost with a membership plan designed for your specific needs.

All memberships are individual memberships and are not transferable. Any person employed by or affiliated with a cooperative association, engaged in providing professional services for cooperatives, or otherwise engaged in the furtherance of cooperative principles is eligible for membership. National membership dues are $175 annually and cover 12 months of benefits from the date enrolled.

Chapter membership is required. Chapters have been organized by region as described below. Members usually affiliate with the chapter covering the area in which they live or work. However, NSAC recognizes that for professional, geographic, or other reasons members may prefer to affiliate with a different chapter or with more than one chapter. The Electric Cooperative Chapter is a national chapter. Those affiliated with an electric cooperative usually join the Electric Cooperative Chapter and the geographic chapter in their area.

Personal/Professional Information

First Name

Middle

Last Name

Salutation (name you prefer to be called by if different from above)

Designations

Occupation

Job Title

Preferred Email Address

Alternate Email Address

Preferred Telephone Number

Ext:

This is my:

Office number

DID number

Cell number

Direct Dial Phone Number (note, this number will not be published)

Ext:

Cell Phone Number (note, this number will not be published)

Enter your preferred mailing address below (Please no PO Boxes):

This is my:

Work Address

Home Address

Street Address

City

State

Zip/Postal Code

Country

I am:

Male

Female

I was referred to NSAC via:

Website

Social Media

Educational Event

CLN

Member

If referred by a member, please enter their name below:

Are you a former member of NSAC?

Yes

Coop or Organization Information

Coop/Organization Name:

Mailing Address (if you did not use it as your preferred address above)

City

State

Zip/Postal Code

Country

Work Phone

Ext

Fax

Toll-Free

Coop/Organization Email Address

Coop/Organization Website URL

CO-OP Type If your firm is not a cooperative, please choose "Not a Cooperative".

Chapter Selection

Please select at least one chapter you would like to join from the list below: (you may join multiple chapters)

Chapter	States Covered	Dues
Electric Co-op	Nationwide	$25
Far Western	AZ, CA, HI, NV, UT	$20
Great Lakes	MI, WI, IL (Northern)	$10
Mid-West	CO, KS, NE, NM, OK	$10
Mississippi Valley	AR, IA, IL, IN, KY, MO, MS, OH	$20
North Central	MN, ND, SD	$10
Pacific Northwest	AK, ID, MT, OR, WA, WY	$20
Atlantic	DE, DC, MD, PA, PR, VA, WV, CT, ME, MA, NH, NJ, NY, RI, VT, AL, FL, GA, NC, SC, TN	$30
Texas	LA, TX	$10

Billing Contact Information Same as above

Contact Name

Cooperative/Firm Name

Mailing Address (Please no PO Boxes)

City

State

Zip/Postal Code

Country

Email Address

Phone

Ext:

Payment Information

Total to Charge

Promotional Code

Payment Method:

Visa

Master Card

American Express

Card Number

CVV2 Code (3 or 4 digits on back of card)

Credit Card Expiration Date

Name on Card

Approval of this application is subject to final endorsement by the Executive Board.
If you prefer to mail in an application with a check or money order, click here to download and print the membership application.