2012 HAMILTON COUNTY BAR ASSOCIATION APPLICATION

Name:                           _______________________________

 Office/Law Firm:            _______________________________

 Address:                       _______________________________

                                     _______________________________

                                     _______________________________

 Phone No.:                   _______________________________

 Fax No.:                       _______________________________

 E-mail:              _______________________________

Please check if you wish to serve on a committee:

 _______            Nominating

_______            Judicial Liaison, Procedures and Forms

_______            Continuing Legal Education

_______            Ethical Standards

_______            Social

_______            Public Service

_______            Public Relations

_______            Records and Awards

Please check one of the following:

 _______            Regular Member (your principal office for practice located in Hamilton County) $50 for one-year membership)

 _______            Associate Member (your principal office for practice located outside  Hamilton County) $30 for one-year membership)

Please make dues payable to the Hamilton County Bar Association and return to:

Jillian Keating, Treasurer
HAMILTON COUNTY BAR ASSOCIATION
c/o COOTS, HENKE & WHEELER

255 E. Carmel Drive

Carmel, IN  46032

If you would like your area of practice listed in our directory and on our website, please indicate your primary practice area(s)

____ Divorce                                         ____ Criminal Defense

____ Estate Planning/Probate                ____     Personal Injury

____ Bankruptcy                                    ____ Contracts

____ Mediation                                      ____ Adoption

____ Guardianships                               ____ Business Law

____ Traffic Violations                           ____ Elder Law

____ Custody and Support                    ____ Other _________________