GTLA Bar Association

Member ID

First name

Last name

Organization

e-Mail

Phone

Fax

PO Box

Street Address

Town

State

Zip Code

Headshots

GTLA can use my headshot taken at the bar dinner.

Use an existing photo (The bar will ask for a copy).

I do not want my photo in the photo directory.

Bar number

Job title

Pro Bono Hours

Where did you do Pro Bono hours?

Please also list other bar admissions you may have.

Website

Directory text

Over the next year, can we add your name to the referral list?

Yes

No

If yes, what are your practice areas?

Directory listing text

Attorney Directory