Please Insert Personal Information
Note: Fields marked with ( * ) are required.
First Name
*
Last Name
*
M.I.
Firm Name
Address
City
State
Zip
Phone
*
Fax
Ex: (212 555-5555)
E-Mail
*
Website
Year of Admission to New York Bar and Department:
*
Other Admissions:
Other Bar Associations:
Type of Practice (Check as applicable)
Legal Aid
18-B/CJA Panel
Private Practice - Solo/Small Firm
Private Practice - Large Firm
State Criminal Practice
Federal Criminal Practice
Contact Preference
(We prefer E-Mail. Please check only one box)
E-Mail
Regular Mail
Fax
Telephone
Membership Type
Select Type of Membership
Past President
Board of Directors
Associate
Honorary
Public Defender
If not listed, insert New Category here
Note
: 2005 Annual Dues For All Members is $100.
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