Application For Admission To The Roster Of Accountants Authorized To Conduct Municipal Audits - Oregon Board Of Accountancy Page 4

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OREGON BOARD OF ACCOUNTANCY
APPLICATION FOR ADMISSION TO THE ROSTER OF ACCOUNTANTS
AUTHORIZED TO CONDUCT MUNICIPAL AUDITS
10. CONTINUING EDUCATION DETAIL REPORT
Only Basic (Level 1) or Intermediate (Level 2) programs are eligible. Programs that are Advanced (Level 3) or Update (Level
4) may not be included in the hours required for Admission to the Municipal Roster. If a course is self-study, submit the 3-
digit QAS sponsor.
Please refer to the “Subject Requirements” on page 1
Sponsor &
QAS
Title of Program
Number
0
0
0
0
0
0
0
0
0
0
0
0
0.00 0
0
0
Total Hours Claimed
11. I understand that the act of filling out this application constitutes an agreement between me and the Board that I will
observe the requirements of OAR 801-020-0690; Qualifications for Admission to Roster. I certify to the truth and accuracy of
all statements and answers made in this application. I understand that before applying, I must have already completed the
required number of continuing education hours listed in OAR 801-020-0690.
Date
Signature
ANY FALSE STATEMENT OR MISREPRESENTATION ON THIS APPLICATION
IS CAUSE FOR DENIAL OF THE APPLICATION OR
REVOCATION OF ANY LICENSE ISSUED UNDER THIS APPLICATION

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