I hereby apply for membership in the Indianapolis Bar Association. In the event I am admitted to the membership in the Association, I agree to abide by its Articles and By-laws.

1. Personal Information
Title*:  Mr.   Mrs.    Ms.    The Hon.
First Name*	Middle Name	Last Name*	Suffix
Maiden	Call Name/Nick Name
Date of Birth*
Attorney #*	Spouse
Preferred E-mail*

2. Office Address
Firm/Business Name
Street*
City* State* Zip*
Firm Web site
Office Phone*
Office Fax*
Office County*

3. Home Address
Street
City State Zip
Home Phone
4. Other Information

Please send my mail to* Office Address     Home Address

IBA Legal Directory profile, please list*:
Office Address    Home Address     Do Not List

Year & State Admitted to Practice*(ie. NY 2002)
Year Graduated*
Law School Attended*
Areas of Practice
Other professional affiliations
Foreign Language(s)
Race (OPTIONAL)  African American      Caucasian       Other Asian American Hispanic

6.	Sections/Divisions Please check any areas in which you might wish to participate. Cost is $20 per section or division
	Alternative Dispute Resolution Section		Appellate Practice Section
	Business Law Section		Commercial and Bankruptcy Law Section (including creditors' rights and consumer law)
	Criminal Justice Section (including substantive and procedural criminal law matters)		Environmental Law Section
	Estate Planning and Administration Section		Family Law Section (including dissolution, custody, and adoption)
	Government Practice Section		Health Care Section
	International Law Section		Judicial Section
	Labor and Employment Law Section (including civil rights matters)		Land Use Section (including zoning, traffic drainage, and sanitary sewers)
	Litigation Section		Public Sector Section(for Government Members only)
	Intellectual Property Section		Senior Counsel Division (25 years of experience or 55 years of age and older)
	Sole Practitioner/Small Firm Practice Section		Sports and Entertainment Law Section
	Taxation Section (including federal/state income tax, corporation tax, pension, and profit sharing)		Women and the Law Division
	Young Lawyers Division

8.	Membership Categories
Check one of the Categories*
	* Resident Member (Office is located in Marion County) For the calendar year he or she is first admitted to the Bar of any state, territory or district of the United States, if this admission occurs after October 1, for the 1st calendar year thereafter: $50 for the 2nd, 3rd and 4th calendar years thereafter: $95 for the 5th, 6th and 7th calendar years thereafter: $125 for the 8th and 9th calendar years: $195 for the 10th and each subsequent calendar year thereafter: $225
	Non Resident Member (Office is not in Marion County) For each calendar year thereafter: $95
	Special Member (Check Qualifications Below) For each calendar year thereafter: $95    Judiciary (Presiding in Marion County): $95    Law Faculty (Full-time faculty member of any accredited educational institute in Indiana)
	Government Member (Full-time government employees only). For each calendar year thereafter: $80
	Life Member (70 years of age and older) For each calendar year thereafter: $50

Will Mail Check

Please make check payable to Indianapolis Bar Association and mail to:
107 N. Pennsylvania St., Suite 200, Indianapolis, IN 46220

Credit Card:

	Mastercard		Visa
	American Express		Discover

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Account#
Exp. Date