LMFBA Membership Application

2017 Membership Application
Name*

First NameLast Name
Firm/Agency/Company*
Address*

Street Address

Street Address Line 2

CityState

Zip Code
Work Phone*

Area CodePhone Number
Other Phone

Area CodePhone Number
E-mail*
CA State Bar #
Year Admitted:
Other State Bar #
Year Admitted:
Law School
Year Graduated:
Area(s) of Practice
Are you an SCBA Member?

YesNo
Interested in becoming a mentor?

YesNoOther
Please indicate your interest in a particular type of event or topic for discussion:
Do you want to be included in a directory to be made available to members of the Association?

YesNo
Dues per calendar year are as follows (check one):

$0 Law Student$18 Attorney, practicing 1-3 years$54 Attorney or individual$154 LMF Bar Association Benefactor
Should be Empty:

2017 Membership Application