York County Bar Association
 
Association-Membership-Application
York County Bar Association Membership Application
 
Please fill out the following:
Last Name: ________________________
First Name: ________________________ MI: _____________

Bar Exam Passed: _____ February _____ July

Date of Admission to the PA Supreme Court: ____/____/____ Supreme Court I.D. Number: _____________

Have you ever been a member of the Pennsylvania Bar Association? ____ Yes (see below) ____ No

If Yes, Earliest Date Admitted _____/_____/_____

Admission to other states and dates admitted:

State: _____________________  Date Admitted: ___/____/____
State: _____________________  Date Admitted: ___/____/____
State: _____________________  Date Admitted: ___/____/____
Firm Information:
 
Type of Practice (Check One): ____ Firm ____ Sole Proprietor ____ Corporate ____ Government
Law Firm Name (If Any): _____________________________________
 
Email: ________________________
 
Address: ______________________________
City: _________________ State: _____ Zip Code: _________

Describe your type of practice: _______________________________________________________________

Phone Number: (____)_____-______
Fax Number: (____)_____-______
Direct Line: (____)_____-______
Mobile Line: (____)_____-______

Personal Information:

Home Address: _________________________
City: _________________ State: _____ Zip Code: _________
 
Home Phone Number: (____)_____-______
Fax Number: (____)_____-______
 
Date of Birth: _____/_____/_____
Spouse Name: ____________________________
 
Preferred Mailing Address (Home/Firm): ____________

School Information (Name of School, Graduation Date):

College: __________________________________________ _____/_____/_____

Law School: __________________________________________ _____/_____/_____

Sponsor Information (please ask your sponsor to sign):

Sponsor Name: ___________________________________________________________________________

Sponsor Firm: ____________________________________________________________________________

Sponsor Address: __________________________________________________________________________

Sponsor Signature: ______________________________________________________________________________

I hereby apply for membership in the York County Bar Association. I acknowledge and understand that in order to complete my membership in the Bar Association, I must pay any applicable fees. I also must attend the orientation program presented by the Bar Association or view the orientation video at the Bar Center, if I qualify for the Young Lawyer Section. Presentation to the bench of the York County Court of Common Pleas occurs in December.

Signature of Applicant:
 
______________________________________________
 
Date of Signature: ______/______/______

Mentor Information (For Completion By Bar Association Staff):

Mentor Named by Bar Association: ___________________________________________________________

Mentor Assigned by: _______________________________________________________________________

Date Mentor Assigned: _____/_____/_____

 





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