MEMBERSHIP APPLICATION Name * First Name Last Name Email * Organization Name * Position Title Please select one of the following that best describes your primary responsibilities in your role, as it relates to diversity, inclusion, and equity work: * Practitioner: a person actively engaged in an art, discipline, or profession Professional: engaged in a specified activity as one's main paid occupation rather than as a pastime Consultant: a person who provides expert advice professionally Other Were you referred by a current DIPCPA member? * Yes No If yes, please enter the name of the current DIPCPA member. Thank you for your interest in DIPCPA. Our membership director will promptly review your application and contact you with further details.