FOOTHILLS BAR ASSOCIATION

OF SAN DIEGO COUNTY

P. O. BOX 1077

EL CAJON , CA 92020

(619) 588-1936      FAX: (619) 442-8060

MEMBERSHIP APPLICATION

  The FBA membership year is July 1 - June 30.

  **DUES FOR FIRST-TIME APPLICANTS WHO HAVE BEEN A MEMBER OF THE CALIFORNIA STATE BAR FOR LESS THAN ONE (1) YEAR = $40.00; DUES FOR LAW STUDENTS = $25.00**

Please print or type:         [   ]  New      [   ]  Renew with changes as noted [   ]  Renew - no changes (COMPLETE ‘**' AREAS)

** Name: ____________________________________________________________________________

Name of firm: _________________________________________________________________________

Office Address: _______________________________________________________________________

Office Phone: ___________________________  Fax: _________________________________________                                                 

E-Mail Address: ______________________________________________________________________

•  I understand that by providing my fax number and email address, I hereby consent to receive faxes and email messages sent by or on behalf of the Foothills Bar Association.

•  Further, I agree that my professional contact information may be published on the Foothills Bar Association website and in the annual Foothills Bar Association Attorney Directory.

•  If you do not want your professional information published in the directory or on the website, please initial here. ________

Foreign Languages Spoken: _____________________________________________________________

I am a member in good standing of the State Bar(s) of: __________________________________________

CA Bar #:  ______________  Year Admitted to Practice: ________________________________________                                                      

Are you interested in becoming actively involved? (please circle one below)

• Yes, I would like to become actively involved, and have time to devote.
• Yes, I would like to become actively involved, but have limited time to devote.
• No, I do not wish to be actively involved, but do wish to take advantage of FBA membership benefits.

If you would like to be actively involved and have time to devote would you like to hold a position?
(please circle one) Yes No

If you answered yes, what committee and/or position are you interested in? ___________________________

Please choose a section: Family Law, Estate Planning, Civil Litigation, Criminal

Please choose a committee: Advertising Annual Dinner Golf Tournament Hard-to-Get Seminar Law Day
MCLE Membership Monthly Newsletter Website

** Date:  __________________________          _______________________________________________
                                                                                       ** Signature of Applicant

Please return the completed Membership Application, together with your check for $55.00 membership dues made payable to
Foothills Bar Association and mail to:

          Foothills Bar Association, P. O. Box 1077 , El Cajon , CA 92020
www.foothillsbar.org

Or fax the application with your credit card information to 619-667-4580

Credit Card Number: __________________________________________________ Security Code: __________

Name on Credit Card:___________________________________________ Expiration month/year: ___________

CHECK AREAS OF PRACTICE TO BE INCLUDED IN   THE FOOTHILLS BAR ASSOCIATION

TELEPHONE DIRECTORY AND ON THE FOOTHILLS BAR WEBSITE

[   ]     Administrative                                             [   ]     Legal Malpractice

[   ]     Adoptions                                                    [   ]     Mechanic's Liens

[   ]     Appellate                                                      [   ]     Medi-Cal

[   ]     Aviation                                                        [   ]     Mediation

[   ]     Banking                                                         [   ]     Medical Malpractice

[   ]     Bankruptcy                                                   [   ]     Military

[   ]     Business/Corporate                                    [   ]     Municipal

[   ]     Civil Litigation                                             [   ]     Personal Injury

[   ]     Collections/Consumer                                [   ]     Probate

[   ]     Commercial/Construction                          [   ]     Public Defender

[   ]     Conservatorship                                          [   ]     Real Estate/Land Use/Environment

[   ]     Criminal                                                         [   ]     School

[   ]     Dental Malpractice                                      [   ]     Securities

[   ]     Elder                                                              [   ]     Sports/Entertainment

[   ]     Eminent Domain                                          [   ]      Social Security

[   ]     Employment                                                 [   ]      Worker's Compensation                

[   ]     Estate Planning/Wills/Trusts                     

[   ]     Family/Domestic                                         LIST ALL AREAS OF

[   ]     General                                                         CERTIFIED SPECIALIZATION

[   ]     Guardianship                                     

[   ]     Home Owners Association                        

[   ]     Immigration

[   ]     Internal Revenue Service/Tax

[   ]     Insurance

[   ]     Intellectual Properties

[   ]     Juvenile

[   ]     Landlord/Tenant