Membership Information & Application Form

Member Change of Address:

Have you moved? Changed jobs? New email address? If so, please go to the IMA National Website, (Go to( https://www.imanet.org/membership.asp), sign into your account (your member id# is your username)) and update your information. Our chapter uses information from IMA National for our contact database, if it's not updated, then you won't receive information from us. If the National website doesn't accept your updates, please call them at 1-800-638-4427 to update the information.

Appliction for Membership Form:

This form should be used for those residing in the U.S., Canada or Mexico. If you reside elsewhere, please use our International application form.
If you are entering the Chinese version of the CMA program, please click here. 如果您欲参加中文版CMA考试，请点击这里.

If you are using this form to renew a current membership, you can use your credit card. If you are paying by another means, please contact a Member Service Associate at 800-638-4427.

Please set aside 10 minutes to fill out this form. You will need to have your credit card information ready or Download the Membership Application Form in PDF format and fax the completed form to (201) 474-1600..
.
Find a Chapter.
* Indicates required field.

Member Information.
* Gender: Male, Female
Name Prefix: Mr. Ms. Mrs. Miss Sir Dr. Hon.
* First Name:
Middle Initial:
* Last Name:
Suffix: Jr. Sr. III IV V
Date of Birth: (mm/dd/yyyy)
* Home Address:
Apt. No., Fl. No.
* City:
* State/Canadian Province:
* Country: United States, Canada Mexico .
* Postal/Zip Code:
Include Area/Country/City Codes for all phone numbers.
Home Phone:
Bus. Phone: ext:
Fax:
* E-mail Address:

* Industry Sector: Education, Healthcare, Media and Entertainment, Construction, Mining, Agriculture, Manufacturing, Transportation, Communication, Utilities, Wholesale/Retail Trades, Finance, Insurance, Business Services, Real Estate, High tech, Nonprofit, Government, Pharmaceuticals & Biotechnology, Other.
* Job Title: Academic, Accountant, Administrative, Analyst, Chief Financial Officer, Consultant, Controller, Corporate Officer, Director/Manager, Executive Officer, Other, Programmer, Supervisor, Vice President.
* Area of Responsibility: Budgeting and Planning, Corporate Management, Cost Accounting, Education, Environmental Accounting, Finance, General Accounting, General Management, Governmental Accounting, Information Systems, Internal Auditing, Other, Personnel Accounting, Public Accounting, Retired, Risk Management, Student, Taxation .

Please note your contact preference: Home, Business .
* Have you ever been convicted of a felony?: No, Yes
Further instructions if checked yes. .
.
Please indicate your IMA PLC User ID: .

Company Information: .
If you are applying for Student Membership, please note your school information under "Business Information." .

Company Name: .
Title:.
Business Mailing Address: .
Suite No., Fl. No.: .
City:.
State/Canadian Province:.
Country: United States, Canada, Mexico.
Postal/Zip Code:.

Education History
Undergraduate Degree: Associates, Bachelors .
Major: .
School: .
(expected)Graduation Year: .
.
Graduate Degree: MBA, Masters, Doctorate.
Major: .
School: .
(expected) Graduation Year:.
Professional Designations Earned: CPA, CFA, CIA, Other: .

Member Profile .
Do you have international responsibilities? Yes, No.
Does your company have an international location? Yes, No.
Who will pay your IMA dues?
You, Your Company.

Is your organization:
Public Sector, Private Sector, Non Profit, Government .

Are you a member of any other association?
AAA, CFA Institute(AIMR), IIA, AFP, ASWA, AICPA, FEI, Other: .

What role do you play in these associations?
Chapter Executive, Member, National Executive Volunteer, Ongoing Speaker/Educator, Regional Executive Volunteer.

What are you looking for most from your IMA Membership?
Certification, Prof., Networking, Education, Other:.

How did you learn about the IMA?
Chapter Meeting, IMA Educational Program, IMA Website, Industry publication, Marketing piece, Company recommended, Industry associate, Professor, Other:, Other Website: .

Number of employees in your company or organization:
Under 50, 51-100, 101-200, 201-500, 501-1,000, 1,000-10,000, Over 10,000.

Company current annual revenues:
Under $1 million, $1-$10 million, $10-$100 million, $100-$500 million, $500 million -$1 billion, $1-$5 billion, $5-$10 billion, Over $10 billion.

Chapter Affiliation
Your Choice of Chapter/Student Chapter
*Chapter Name:
Akron (OH), Alaskan (Anchorage), Tech Valley, Albuquerque, Allegheny Mountains (Olean), Altoona Area, Amador Valley (Pleasanton, CA),Ann Arbor, Atlanta, Augusta, Austin Area, AZ Valley of the Sun (Phoenix), Bakersfield Area, Baltimore, Bangor-Waterville, Bellevue Eastside (Seattle), Bergen-Rockland-Meadowlands (Fort Lee), Birmingham, Bloomington Indiana, Blue Grass Area (Lexington), Boston, Boulder Valley (Boulder), Buffalo, Calumet (Hammond), Canton, Catawba Valley (Hickory), Cedar Rapids, Central California (Modesto), Central Illinois (Bloomington - Peoria), Central Minnesota (St. Cloud), Charleston-Trident, Charlotte, Chattahoochee Valley (Columbus), Chattanooga, Chicago, Chippewa Valley (Eau Claire), Cincinnati North (Hamilton - Middletown), Cleveland, Cleveland East (Shaker Heights - Euclid), Coastal Fairfield County, Columbia, Columbus, Dallas Area (Plano - Richardson), Danbury, Dayton, Delaware, Delmarva (Salisbury - Cambridge), Denver - Centennial (Denver), Des Moines, Detroit, Diablo Valley (Walnut Creek)Dubuque Tri-State, Eastern Connecticut, El Paso, Erie, Eugene-Springfield, Evansville, Florence Area, Fort Wayne, Fort Worth, Fox River Valley (Aurora - Elgin), Fresno Area, Gaston-Carolinas (Gastonia), Grand Rapids, Greater Greenville, Greater Milwaukee, Greater Ozarks (Springfield), Greater Philadelphia, Greater Topeka Area, Green Mountain (Burlington), Gulf Coast (Mobil) Hampton Roads (Norfolk - Virginia Beach), Hartford, Hawaii (Honolulu), Heart of Wisconsin (Wausau), Houston, Illowa (Moline/Davenport), Indianapolis, Inland Empire (Riverside - San Bernardino), Ithaca-Cortland, Jacksonville, Johnstown, Joplin Tri-State, Kalamazoo, Kansas City, Knoxville, Lake Superior (Duluth - Superior), Lake West Point Area, Lancaster, Lansing-Jackson, Las Vegas, Lehigh Valley (Allentown) Lima, Long Island (Garden City), Los Angeles Metro, Louisville, Madison, Mass Route 128">(Dedham), Massachusetts North Shore (Lynn), Michiana (South Bend - Elkhart), Michigan Upper Peninsula (Marquette - Houghton), Mid-Florida (Orlando), Mid-South - Memphis Area, Minneapolis (North Minneapolis), Montgomery, Morris-Essex (Florham Park), Mountain Empire (Kingsport), Mt. Rainier (Tacoma), Muscle Shoals (Sheffield - Florence), Nashville, Nation's Capital, New Hampshire (Manchester), New Haven, New Orleans, New York, Niagara, North Carolina Triangle Area, North Georgia (Dalton), North Jersey Shore (Monmouth Park), North Penn (Norristown), Northern Kentucky (Covington), Northwest Arkansas (Fort Smith), Northwest Suburban Chicago (Des Plaines), Oakland-East Bay (Berkeley), Ohio Mid-Eastern (New Philadelphia - Dover), Omaha, Orange County (Newport - Anaheim), Packerland (Greenbay), Palm Beach Area (West Palm Beach), Peninsula-Palo Alto, Pennsylvania Northeast (Scranton - Wilkes Barre), Piedmont Triad NC, Pikes Peak (Colorado Springs), Pittsburgh, Polk County Florida (Lakeland), Portland, Princeton, Providence, Quincy Area, Raritan Valley (Somerset), Reading, Redwood Empire (Santa Rosa), Reno Area, Richmond, Rochester, Rockford, Sacramento, Saginaw Valley (Midland - Flint), Salem Area, Salt Lake Area, San Antonio, San Diego, San Diego North County (Carlsbad), San Francisco, San Gabriel Valley, Sangamon Valley (Decatur - Springfield), Santa Barbara, Savannah, Seattle, Silicon Valley, South Bay (Palos Verdes), South Birmingham (Fairfield - Bessemer), South Central Indiana (Columbus), South Central Minnesota (Mankato), South Florida (Ft. Lauderdale – Boca Raton), Southeast Alabama (Dothan), Southeastern Massachusetts (New Bedford), Southern Maine (Portland), Southern Minnesota (Rochester), Southwest Florida, Spartanburg Area, Springfield, St. Joseph-Pony Express, St. Louis, St. Paul, Stockton Area, Syracuse,Tampa Bay, Tech Valley, Toledo, Toronto, Treasure Valley, Tucson, Tulsa, Virginia Peninsula (Newport News - Hampton) -->, Virginia Skyline (Waynesboro - Harrisonburg), Washington Tri-Cities (Richland), Waterbury, Waterloo-Cedar Falls, West Alabama (Tuscaloosa), West Chester Pennsylvania, Westchester Gateway (White Plains), Western North Carolina, Westmoreland County (Greensburg), Wichita, Wilmington, Winnebagoland (Appleton - Oshkosh), Wisconsin Lakeshore (Sheboygan - Manitowoc), Worcester Area, York .

OR * Chapter-At-Large .
(Check if no chapter affiliation desired. For more info call 800-638-4427).

Certification Program .
If you are applying to the CMA Certification Program, please complete the following section and pay the $200 certification entrance fee or $75 for Student/Academic members. (Please note, this entrance fee will expire in four years. If a candidate has not completed the exam by that time, the entrance fee must be paid again.).

Later - You can sit for the exam without submitting your educational credentials, but you will not be certified until your credentials are verified.

College Graduate - Submit official transcript showing university degree conferred and official university seal or arrange for university to send proof of degree directly to the ICMA. If you have more than one degree, submit only one transcript. Further information for those who earned their degree outside of the U.S.

Name on transcript (if different from above):
GMAT or GRE Scores - Provide copy of scores to ICMA.
U.S. CPA Exam - Arrange to have proof of U.S. CPA examination completion sent directly from your State Board of Accountancy to the ICMA.
Applying for Certification as a Student - Upon graduation, be sure to arrange for an official copy of your transcript to be sent to the ICMA.
Applying for Certification as an Academic - In addition to confirming your educational qualification, please provide a letter on school stationary affirming full-time teaching status.

Membership Information/Dues - All payments must be in U.S. Dollars:

Regular Membership:
(You must reside in the U.S., Canada, or Mexico, if you reside elsewhere, please use our International application form.)
1 Year - $195
$

Young Professional:
(You must be under the age of 33 and reside in the U.S., Canada, or Mexico)
1 Year - $130
$

Academic:
(You must be a full-time faculty member and reside in the U.S., Canada, or Mexico)
$98
$

Student:
(You must take at least 6 or more hours per semester, reside in the U.S., Canada, or Mexico, and never have been in another membership classification)
Year of Graduation:
$39
$

Optional Services (IMA® Membership Required)
Member Interest Groups:
Controllers Council 1 year - $75
Cost Management Group 1 year - $75
Small-Business Council 1 year - $75

CPE Offerings: (prices valid through 12/31/09)
Subscription Courses: Valid for 365 days from date of purchase.
IMA Knowledge Exchange (144 NASBA CPE) 1 year - $289*
IMA Advantage (200+ NASBA CPE) 1 year - $289*
IMA Knowledge Exchange/Advantage Combination Package
(300+ NASBA CPE) 1 year - $439*
IMA CPEdge (45 NASBA CPE) 1 year - $195*
Specialized Courses: Valid for 180 days from date of purchase.
IMA Ethics Series: Success Without Compromise (4 CPE) $75**
IMA Ethics Series: Fraud in Financial Reporting (2 CPE) $59**
IMA Ethics Series: Corporate Ethics: From Policy to Practice (2 NASBA approved CPE) $40**
IMA Ethics Series: Embracing Ethics (2 NASBA approved CPE) $45**
IMA IFRS Series: Embracing International Financial Reporting Standards (IFRS): A Background Primer (2 NASBA approved CPE) $50**
*Valid for 365 days from date of purchase
**Valid for 180 days from date of purchase
$

Certification:
Check here if you are applying for the CMA program. You must complete the ICMA Program section above. (Non-refundable, expires in four years.) $200
Student/Academic member certification entrance fee (US, Mexico, or Canada. Non-refundable, expires in four years.) $75
Exam Waiver Fee (See www.imanet.org/certification.asp for more information). $190
Certification Entrance Fee - $200
Certification Entrance Fee for Students/Academics - $75
$

Registration Fee
(Applies to all new members except Students and Young Professional) $15 $

Total: $

IMA occasionally makes available its members' addresses (excluding telephone and e-mail) to vendors who provide products and services to the management accounting and finance community. If you prefer NOT to be included in these lists, please check this box.
Strategic Finance Magazine
Subscription rates per year:
Members: $48 (Included in dues, nondeductible)
Student Members: $25 (Included in dues, nondeductible)
Nonmember: $195
Nonprofit Library: $98

Management Accounting Quarterly:
Subscription rates per year:
Members: $10
(Included in dues, nondeductible)
Nonmember: $60

Payment Information
* Credit Card: MasterCard, Visa, American Express, Discover
* Card Number:
Name (as appears on Card):
* Expiration Date: / ,(mm/yyyy)

Promo Code (if applicable):

I affirm that the statements on this application are correct and agree to abide by the Standards of Ethical Conduct.