Membership Application Form

Membership Application Form

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

New Membership
Contact Information:
Name*

PrefixFirst NameMiddle NameLast NameSuffix
Mailing Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Work Number*

Area CodePhone Number
Cellphone Number

Area CodePhone 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 practiceAssociate - 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 53707-0811Request Online Payment
Term*

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

YesNo
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:

Contact Information: