JUSTINIAN SOCIETY OF LAWYERS
Application for Membership
Type of Membership:
_____ Full Member ($125 Dues) _____ Retired ($50
Dues) ____ 1st Year Lawyers: (No
Fee)
____ Student ($25 Dues. No fee for student members
of Justinian Law School Chapters)
Please complete the following survey and return it with your dues check to:
THE JUSTINIAN SOCIETY OF LAWYERS
c/o Nina Albano Vidmer
(708) 338-0760 Phone · (708) 338-0997 Fax
Name: __________________________________________________________________________
Last First Middle
Employer: _______________________________________________________________________
Firm name, business, corporation, government agency
Business Address: __________________________________________________________________
Number Street Suite
_________________________________________________________________________________
City State Zip
Business Phone:(_________)_______________________Fax:(_________)_____________________
Home Address: ____________________________________________________________________
Number Street Apt. # City
_________________________________________________________________________________
State Zip
Home Phone:(_________)____________________________________________________________
Are you admitted to practice in
states other than
Year Admitted to Bar __________ Year Admitted to Justinian Society _______
Please list your e-mail and/or URL address:
E-Mail Address:
_______________________ URL ________________________
1st Year Lawyers and Students only:
SPONSOR NAME:
________________________________________________
Check one
___ REGULAR MEMBER:
$125.00
(Regular Membership Includes $20 contribution to the JUSTINIAN SCHOLARSHIP FUND and free subscription to Fra Noi).
___ RETIRED : $50.00
___ 1st
Year Lawyers: No Fee
___ STUDENT: $25.00 (No
fee for student members of Justinian Law School Chapters)
Optional
Contributions
_____
Law Scholarship Fund
_____
Children’s Endowment Fund
I have enclosed $_________for
Dues
I have enclosed $_________for
the Law Scholarship Fund
I have enclosed $_________for
the Children's Endowment Fund
I have enclosed a TOTAL of.... $_________
Please make
your dues check payable to: THE JUSTINIAN SOCIETY OF LAWYERS
Complete
Area of Concentration Form on opposite side.
Justinian Societey of Lawyers
If you are a member of any
bar affiliates, please list below
___ ISBA ____ CBA ___
AREA OF CONCENTRATION
(Check no more than three)
Students, retired and judicial members should only check off those
areas.
__ Judge (61) __
Retired (65) __
Student (64)
__ Public Service (60) __
Private Co. Affiliation (62) __ Educator
(63)