Law Student Membership Application

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Name(Required)

First Last

Bar ID/NCBE no. (if applicable)

Law School(Required)

Year of Graduation(Required)

Permanent Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Email(Required)

Enter Email Confirm Email

Phone(Required)

Country Phone Number

Date of Birth(Required)

Law School Certification:

Current Date

Signature(Required)

Areas of Interest(Required)

Activities & Leadership Roles(Required)

Reason for Joining:(Required)

LAKE COUNTY BAR ASSOCIATION
25 North Park Place
Painesville, OH 44077
(440) 350-5800
E-mail: barassociation@lakecountyohio.gov
www.lakecountyohiobar.com