We, the undersigned, apply to affiliate with the American Woman's Society of Certified Public Accountants (AWSCPA), on this _____ of ________________, _____ as an affiliated group of AWSCPA, located in _______________, _______.

We agree to uphold the bylaws of the American Woman's Society of Certified Public Accountants, and attach a copy of our proposed corporate bylaws which in no way conflict with the national bylaws of AWSCPA.

We attest that we are members in good standing of the American Woman's Society of Certified Public Accountants or are hereby applying for membership in AWSCPA (membership applications and dues are attached).

Please sign on the appropriate line, and print your name beneath the line.

NOTE: A total of ten members of AWSCPA must sign the applicaton (including the president or acting leader of the affiliated group).