Membership Application | Evansville Bar Association

Membership Information

Category*

First Date Admitted to Any Bar Association* This field is not required for Law Students or Paralegal Associates

Attorney No.* This field is not required for Law Students or Paralegal Associates

Basic Information

Prefix

First Name*

Middle Name

Last Name*

Suffix

Nickname/Name Tag Preference

Email Address*

Date of Birth

Gender

Website

Contact Preference

Please contact me through the following:*

Residential Address

Address

Address (con't)

City

State

Zip Code

Phone

Office Address

Address

Address (con't)

City

State

Zip Code

Phone

Fax

Melissa Khan - Edward Jones Financial advisor

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