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Member Information

*First Name:
*Last Name:
Firm:
*Address:

*City:
*State:
*Postal Code:
*Phone:	(XXX-XXX-XXXX)
Cell Phone Number:	(XXX-XXX-XXXX)
*Email:
Website:
Areas of Concentration:

*Membership

*Membership Type:
Your Affiliate:	Affiliate Member ($25 on dues will be deducted)
NELA's Legislative & Public Policy Fund Contribution:	Other Amount:
Sanctions Assistance Fund for Emergency Relief (SAFER) Contribution. More info:	Other Amount:
The Employee Rights Advocacy Institute For Law & Policy Contribution (Tax-deductible as a charitable contribution) More info:	Other Amount:
	Public Advertising on nela.org ($175) - See Find-A-Lawyer Directory.
	I certify that 51% of my employment law practice is plaintiff work.

*Totals

TOTAL:

$ 0.00

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