DIRECTIONS Thank you very much for your submission to the AICPA’s book honoring Sid Kess’s contributions to the CPA profession, tentatively titled The Sid Kess Approach. Please read these directions thoroughly before writing and submitting your story. 1. Complete the Submission Form (starting page 2) in Microsoft Word and email it as an attachment to lessonsfromsid@aicpa.org. 2. Print and sign the Release Form (page 4) and do one of the following: Scan it into PDF format and email it to: bkeating@aicpa.org; Print and fax it to: Brittany Keating at 919-419-5244; or Mail it to: Brittany Keating AICPA Palladian I 220 Leigh Farm Road Durham, NC 27707 DEADLINE: Please submit your story no later than November 18, 2011. Page 1 of 4 SUBMISSION FORM One way to make your story engaging is to bring the reader into your experience. You can do that by emphasizing the details of the story—who you are, where you were in your career during the time period you describe, the specifics of your encounter with Sid, and so forth. Include the emotional side of the story as well, and use concrete language that will help readers picture the events. Most importantly, please emphasize the meaning and importance of what you learned from Sid. Please limit your story to 500 words. Your Name: Your Practice Name: Your Certifications and Affiliations (i.e., AICPA/AICPA member segment and state CPA society membership): Street/City/State Address: Phone: Mobile Phone: Email Address: Best way to communicate with you __ phone __ mobile phone __email Best time of day to communicate with you: Your bio in 30–40 words. Please include something personal about you (e.g., James Smith, CPA, PFP is Managing Partner of Smith Associates in Corpus Christi, TX. He is a member of the Texas State CPA Society and is an avid water skier.). Page 2 of 4 If you discuss a client in your story: ____ Your client’s name is __________________________________________. They have given you permission to share their story with their name attached. ____ Names have been changed. If names have been changed, they will not be revealed in the book. Note: If your story is selected, written proof of this permission will be required, even if names have been changed. Background information for your story: Your title for the story: ______________________________________________________________ Timeframe of the story: ______________________________________________________________ State or geographic region: ___________________________________________________________ Your story (maximum of 500 words): Type or paste your story here: Page 3 of 4 Submission Release Form I understand that the AICPA is preparing, writing, and will publish a work on the subject of Sid Kess’s contributions to the CPA profession, which is tentatively titled The Sid Kess Approach (the Work) forthcoming from AICPA Practice and Industry Publications. I hereby grant permission to the AICPA to quote or paraphrase all or any portions of the included story in the Work. Permission is granted for the current and any future editions of the Work, and derivative works, including but not limited to digital publications, marketing materials, magazine excerpts, and use on AICPA websites. I warrant that any individuals or companies described in the included story have consented to be featured in said story or that their descriptions have been sufficiently changed so as to protect their identity. I understand and acknowledge that the AICPA will be the sole owner of all copyright and other rights in and to the Work. I acknowledge and agree that I am not entitled to receive any form of payment from the AICPA. Agreed and confirmed: _______________________________________________________ Signature ________________________ Date _______________________________________________________ Name (print) ************************************************************************************* Print and sign this Release Form and do one of the following: Scan it into PDF format and email it to: bkeating@aicpa.org; Print and fax it to: Brittany Keating at 919-419-5244; or Mail it to: Brittany Keating AICPA Palladian I 220 Leigh Farm Road Durham, NC 27707 Page 4 of 4