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Name:
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Telephone number:
Name of law school and graduation date (if law student, anticipated date:
Name of business or employer:
State bar admission(s) and year(s) of admission. If you are pending admission, please indicate:
Practice type (e.g., Private, Corporate, Government, Law Professor, Other (please explain)
Please enter your area(s) of practice:
Are you a current or retired judge, special master, mediator or arbitrator? If yes, please provide details:
Are you currently a professor at an university or other higher education institution? If yes, please provide the name of the institution and courses that you teach: