Membership Upgrade Request Form

Membership Upgrade Request

Note: Please do not submit this form unless you want to initiate an upgrade. For information on each level and its benefits, please click here. Once this form is submitted, a staff member will charge the credit card provided within 1-2 business days. Please email membership@cpapsych.org if you have questions about this form. If you do not see a payment plan option (e.g., 6 payments, 5 payments, etc.) below, then we have passed the time frame to ensure that the payment plan is complete by June 15th and that option is no longer available.

If you prefer to download a hard copy of this form, please click here. Once you have filled it out, send it to membership@cpapsych.org or fax to 916-286-7971.

New or Rejoining Members: If you are not a current member of CPA, please do not fill out this form as the new member application is required. Please click here for more information regarding new memberships or rejoining CPA.

Upgrading to Premium: If you are upgrading to the Premium level, and you paid for a Division Membership during your original join/renew invoice, the amount for the Division Membership will be applied as a credit toward the upgrade amount.

Time of Year: If you are requesting an upgrade on/after October 1st, we will process your renewal for the following year versus upgrading. If you have any questions about this, please contact us at membership@cpapsych.org.

What is Tax Deductible?
First Name *
Last Name *
DegreeDegree
Email Address *primary contact: email address
Select New Membership Level *Select the Member Level you wish to upgrade to. Do not select one of the Life Member levels, unless you are a current Life Member.
# of payments (Note: Last payment no later than June 15) *If you wish to pay the upgrade fee in full, please select 1 payment. If you wish to split the upgrade fee into payments, please select the number of payments.	6 Payments 5 Payments 4 Payments 3 Payments 2 Payments 1 Payment
Name on Credit Card *Name on Credit Card
Credit card # *Credit card #
Exp date *Expiration Date		Security Code *Security Code
Billing Address for credit card *Billing Address
Billing: City *Billing: City
Billing State *Billing State		Billing: Zip Code *Billing: Zip Code
80% of CPA dues may be tax deductible as an ordinary and necessary business expense. 100% of CPA-Foundation contributions are tax deductible. Contributions to the CPA PAC are not deductible.
I authorize CPA to charge the above credit card for my upgrade fee. *	Yes