| MEMBERSHIP APPLICATION NATIONAL BAR ASSOCIATION – BEN F. JONES CHAPTER MEMBERSHIP FORM |
[ ] New Member [ ] Renewing Member
1) Personal Information
First Name ____________________ Last Name _ ________________
E-Mail (office) ______ E-Mail (personal)
_____________________
Firm/Company/Agency ___________________________
Street Address ______________________________________________________
Mailing Address
________________________________________________________________________________
City _________________________________________ State ______ Zip ________
Telephone (____) _________________ Fax (____)___________________
Law School ____________________ Grad. Year ___________________
2) Membership Dues
[ ] $25 0-1 Years
[ ] $50 1-3 Years
[ ] $75 3-5 Years
[ ] $100 More than 5 Years
3) Areas of Practice
[ ] Administrative Law
[ ] Elder Law [ ] Labor & Employment
[ ] Agriculture Law [ ] Entertainment & Sports [ ] Landlord/Tenant
[ ] Alternative Dispute Resolution [ ] Environmental Law [ ] Litigation – Civil
[ ] Antitrust [ ] ERISA/Employee Benefits [ ] Litigation – Commercial
[ ] Appellate Practice [ ] Family Law [ ] Patent/Trademark
[ ] Bankruptcy [ ] Franchise Law [ ] Product Liability Law
[ ] Civil Rights [ ] Gaming Law [ ] Real Estate
[ ] Collections [ ] General Practice [ ] Science & Technology
[ ] Communications Law [ ] Government [ ] Social Security
[ ] Construction Law [ ] Health & Hospital Law [ ] Social Security Disability
[ ] Consumer Law [ ] Immigration Law [ ] Taxation – Corporate
[ ] Copyright
[ ] Insurance Law [ ] Taxation – Personal
[ ] Corporate & Business [ ] Intellectual Property [ ] Tort & Personal Injury
[ ] Criminal – Defense [ ] International Law [ ] Transportation Law
[ ] Criminal – Prosecution [ ] Juvenile Law [ ] Trust, Estate Planning & Probate
[ ] Workers’ Compensation
4) Payment Information
Membership Dues $_______ (Check payable to NBA – Ben F. Jones Chapter)
Amount Enclosed $____ (Paid thru MBA)
Please return this form and payment to: NBA – Ben F. Jones Chapter
P.O. Box 3493
Memphis, TN 38173
1) Personal Information
First Name ____________________ Last Name _ ________________
E-Mail (office) ______ E-Mail (personal)
_____________________
Firm/Company/Agency ___________________________
Street Address ______________________________________________________
Mailing Address
________________________________________________________________________________
City _________________________________________ State ______ Zip ________
Telephone (____) _________________ Fax (____)___________________
Law School ____________________ Grad. Year ___________________
2) Membership Dues
[ ] $25 0-1 Years
[ ] $50 1-3 Years
[ ] $75 3-5 Years
[ ] $100 More than 5 Years
3) Areas of Practice
[ ] Administrative Law
[ ] Elder Law [ ] Labor & Employment
[ ] Agriculture Law [ ] Entertainment & Sports [ ] Landlord/Tenant
[ ] Alternative Dispute Resolution [ ] Environmental Law [ ] Litigation – Civil
[ ] Antitrust [ ] ERISA/Employee Benefits [ ] Litigation – Commercial
[ ] Appellate Practice [ ] Family Law [ ] Patent/Trademark
[ ] Bankruptcy [ ] Franchise Law [ ] Product Liability Law
[ ] Civil Rights [ ] Gaming Law [ ] Real Estate
[ ] Collections [ ] General Practice [ ] Science & Technology
[ ] Communications Law [ ] Government [ ] Social Security
[ ] Construction Law [ ] Health & Hospital Law [ ] Social Security Disability
[ ] Consumer Law [ ] Immigration Law [ ] Taxation – Corporate
[ ] Copyright
[ ] Insurance Law [ ] Taxation – Personal
[ ] Corporate & Business [ ] Intellectual Property [ ] Tort & Personal Injury
[ ] Criminal – Defense [ ] International Law [ ] Transportation Law
[ ] Criminal – Prosecution [ ] Juvenile Law [ ] Trust, Estate Planning & Probate
[ ] Workers’ Compensation
4) Payment Information
Membership Dues $_______ (Check payable to NBA – Ben F. Jones Chapter)
Amount Enclosed $____ (Paid thru MBA)
Please return this form and payment to: NBA – Ben F. Jones Chapter
P.O. Box 3493
Memphis, TN 38173
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