Membership

NOTE: * implies that the information in this field is required

Membership Type:
Yearly Membership ($150.00)
Lifetime Membership ($1500.00)
Senior Status ($50.00)

Prefix

First Name*	Middle Name	Last Name*

Suffix	Title

District/DOJ (click here to add multiple entries)
Former US Attorney: yes no District: DOJ Title: Year From*: Year To:

Personal Email Address	Personal Web Address (e.g. www.nafusa.org)

Spouse's Name

Education (click here to add multiple entries. MAX: 250 chars each.)

Practice Area(s) (click here to add multiple entries. MAX: 250 chars each.)

Publication(s) (click here to add multiple entries. MAX: 250 chars each.)

Other Public Office(s) (click here to add multiple entries. MAX: 250 chars each.)

Contact Information (click here to add multiple entries)
NOTE: If you select the contact type "Personal (Confidential)", your contact information will not be listed publicly on the NAFUSA website. All other contact types will be listed publicly on the NAFUSA website.

Type:

Status:

Name:

Address 1:

Address 2:

Address 3:

Address 4:

City: State:

Zip Code: Country:

Phone: Fax:

Web Address:

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