| Bar Association Name:
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Please give your name and
contact information in case of questions regarding
this form:
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| Number of members:
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Dues structure:
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Committees/Sections
Please list the names of committees and sections in your association, i.e. Public Outreach, Young Lawyers, Membership Services, etc. |
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| Website and Listserve |
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| Please provide the e-mail address
of an association leader who would like to be included on a listserv for
the 2009-2010 leadership year: |
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| If not already posted on the State
Bar's Local and Special Purpose Bar Association website,
please provide a website address for your organization: |
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Officer Information
Please enter the name, P#, or address for all those who hold office
during the 2009-2010 leadership year. |
| Officer elections are held:
Election month:
Term length:
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Term Expires:
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P#: |
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Name: |
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Address: |
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City, State, Zip: |
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Phone: |
Fax: |
e-Mail: |
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Term Expires:
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P#: |
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Name: |
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Address: |
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City, State, Zip: |
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Phone: |
Fax: |
e-Mail: |
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Term Expires:
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P#: |
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Name: |
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Address: |
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City, State, Zip: |
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Phone: |
Fax: |
e-Mail: |
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Term Expires:
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P#: |
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Name: |
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Address: |
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City, State, Zip: |
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Phone: |
Fax: |
e-Mail: |
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Term Expires:
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P#: |
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Name: |
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Address: |
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City, State, Zip: |
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Phone: |
Fax: |
e-Mail:
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Term Expires:
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P#: |
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Name: |
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Address: |
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City, State, Zip: |
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Phone: |
Fax: |
e-Mail: |
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Other Information: |
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| Please use the space below to furnish any
information you think will be helpful. |
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Questions? Please
contact Candace Crowley at (517) 346-6319 or ccrowley@mail.michbar.org |