Member Area > Member Type > Event Register

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Username (please don't enter an email address):

Email:

@

Re-enter Email:

@

First Name:

Last Name:

Middle Name:

Create Password:

Confirm Password:

Password must be at least 7 characters in length. Must be a combination of letters and numbers (at least one of each).

Company/Firm Name

Title

Primary Address

Address:

Address Line 2:

Country:

State:

City:

Zip Code:

Secondary Address

All mailings default to the Primary Address unless checked below.

Use for Bar Journal & section mailings

Use for licensing mailings (i.e. bar cards)

Address:

Address Line 2:

Country:

State:

City:

Zip Code:

Business Phone:

Other Phone (not published):

Cell:

Fax:

Website:

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