Membership Type New Renewal

1. Personal Information
Title*:  Mr.   Mrs.    Ms.    The Hon.
First Name*	Middle Name	Last Name*	Suffix
Maiden	Call Name/Nick Name
Date of Birth*
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

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		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		Intellectual Property Section
	International Law Section		Labor and Employment Law Section (including civil rights matters)
	Land Use Section (including zoning, traffic drainage, and sanitary sewers)		Law Student Division
	Litigation Section		Public Sector Section
	Senior Lawyers Division (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.	Paralegal Category/Fee Schedule
Annual Dues: Check one of the Categories*
	If a member of the Indiana Paralegal Association - $55
	If not a member of the Indiana Paralegal Association - $60
Institution Granting Paralegal Certification (If Applicable) Date of Certification

I am a paralegal, legal assistant or any equivalent term and perform paralegal duties at least seventy percent (70%) of the time as is evidenced by [a] an affidavit signed by the employing attorney or a representative of the employing entity or [b] proof of membership as a current voting member of the Indiana Paralegal Association). I hereby apply for enrollment with the Indianapolis Bar Association as a Paralegal Associate Member, and in the event of admission, I agree to abide by your Articles and Bylaws as the apply to Paralegal Associate Members.

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:

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	American Express		Discover

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Account#
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