Company Name

Trading Name (if different)

Business Address

Postcode

Telephone Number

Mobile Number

Email

Website address (Where applicable)

Status of Business

Company Registration Number

Please list below the names and addresses of the Board of Directors of your company

Have you, or any of the Directors, been previously involved in a company which has been a Member of the CPA

If yes, please give details

Have you, or any of the Directors, been involved in a company that has failed e.g Receivership, liquidation, etc.

If yes, please give details

How many years have you been trading?

Can you provide a copy of your latest audited accounts?

Name of Auditor

Auditor Address

Please indicate last year's turnover

What is your main business activity?

What are your main plant and equipment activities? (please tick appropriate boxes)

If other please state

Applicants references:

Is this a CPA member?

Company Name

Name of Contact

Address

Telephone

Email

Is this a CPA member?

Company Name

Name of Contact

Address

Telephone

Email

By ticking this box I declare and confirm that the above information is accurate and true to the best of my knowledge; and I also confirm that I have read the CPA Rules*, and agree to be bound by them.

Name

Job title

Date

Can you please confirm where you first heard of the CPA?

Details/other

First Reason

Second Reason

Third Reason

Other/Reason Details

Join CPA - Online Application Form

First reference

Second Reference