Membership Form and Dues Statement

Fill out the following information (bold fields are mandatory) and click "Submit."

First Name:

Last Name:

Law Firm/Company:

Address:

Address:

City:

State:

Zip Code:

Website:

Email Address:

Business Phone:

Fax:

Area(s) of Specialization:

Year of Admission:

State Bar #:

Are you a member of the Los Angeles County Bar Association?:

Yes
No

Please check the appropriate box:

Member in practice less than 5 years--$25.00
Member in Practice 5 years or more--$80
Sustaining member--$100
Lifetime member--$1,000.00
Friend--$80.00

Credit Card Type:

American Express
Discover
MasterCard
Visa

Credit Card Number: