TAU ALPHA CHI

National Office

50 Hurt Plaza, Suite 1520

Atlanta, Georgia 30303

Office: (404) 659-6261 Fax: (404) 659-5124

The UNIVERSITY OF MISSISSIPPI

TAU ALPHA CHI CHAPTER

MEMBERSHIP APPLICATION

Personal Information

Full Name: ____________________________________________________________________

Nickname: ___________________Email Address: _____________________________________

SS# or Student ID: ______________________________________________________________

Mailing Address: ________________________________________________________________

_____________________________________________________________________________

Telephone: (Home) __________________________

Employer Information (Current or Expected)

Employer Name: ________________________________________________________________

Address: _________________________________________________________________

City, State, Zip ____________________________________________________________

Employment Start Date: _______________ Telephone ______________________________

Membership Status: (Circle one) Alumni Grad Student Law Senior Junior Sophomore

Education Information

Undergrad Degree: ________________ School: ___________________________________

Major: ________________ Date of Graduation(Actual or Expected): ___________________

Graduate Degree: ________________ School: ____________________________________

Major: ________________ Date of Graduation(Actual or Expected): ___________________

(If necessary, attach a supplemental sheet.)

Would you be willing to commit your time to: (Circle any that apply)

Hold an Office Work on a committee Chair a committee Attend Meetings

Other (specify): __________________________________________

If you are unable to participate in any of the above, please comment on the back of this application as to why.

In order to complete your application for membership, Tau Alpha Chi requests that you list all prior and current ACCOUNTING and TAX courses (including all courses repeated).

Course Grade Hours College Attended Professor

____________________________________________________________________________________

(If necessary, attach a supplemental sheet.)

Tau Alpha Chi requests your permission to verify your grades. Your grades will be verified by our faculty advisor. Under no circumstance will any student member have access to your grades without your permission.

I, _____________________________________, do hereby attest that all of the above statements are true,

(Print full name)

and further do give permission to have my grades verified by the Tau Alpha Chi advisor.

Signature of Tau Alpha Chi Applicant

_____________________________________________________________________________________

Signed this ________ day of _____________________, 199__.