Membership Application Form

Membership Application Form

Annual Membership (January 1st to December 31st)
Please choose one: *

New Membership
Contact Information:
Name *

Prefix First Name Middle Name Last Name Suffix
Mailing Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Work Number *

Area Code Phone Number
Cellphone Number

Area Code Phone Number
Email *
example@example.com
Practice Information:
Practice Setting
Practice Area
Current Employer
Title
Membership Type and Dues:
Membership Type *
Membership Type *

Attorney - Licensed to practice Associate - Holder of legal degree (cannot hold office or chair committees) Law Student - (cannot hold office, vote, or chair committees)
Method of Payment *

Mail a check to Law Alliance, 3902 Milwaukee St. # 70811, Madison, WI 53707-0811 Request Online Payment
Term *

January 1 to December 31
Would you like to participate in the Mentoring Program, either as a mentor or mentee? *

Yes No
Committee Selection:
Which of the following standing committees would you like to join? *

Program - Coordinate and plan programs and events throughout the year. Membership - Recruitment, retention, and engagement of members. Outreach - Building relationships with other organizations, including local bar associations, community groups, and the law schools. None
By clicking submit below, I authorize the Law Alliance to process my membership application and add me to it's Membership Directory, Listserve, and online member portal, the Exchange.
Should be Empty:

Now create your own JotForm - It's free! Create your own JotForm

Membership Application Form

Contact Information:

Practice Information:

Membership Type and Dues:

Committee Selection: