Membership Application

Step 1 of 2

2017-2018 Membership Application/Renewal

Waterbury Bar Association
P.O. Box 1767
Waterbury, CT 06721

Please fill out the Membership Application form completely.
Upon hitting submit you will sent to the payment page.

Name:
Firm/Employer:
Firm/Employer Address:
City:
State:
ZIP:
Home Address:
City:
State:
ZIP:
Work Phone:
Home Phone:
Cell Phone:
Email(*):
Website:
Law School and Graduation Year:
Year Admitted to Practice:
Primary Practice Areas:
(e.g., criminal, civil, judicial, etc.)
A.
B.
C.
Additional Comments:
COMMITTEES
Please check any/all Committees you are interested in joining or receiving information from:
Committee: Committee Member: Information Only:
Civil Law:  Civil Law  Civil Law
Communications/Speaker:  Communications/Speaker  Communications/Speaker
Criminal Law:  Criminal Law  Criminal Law
Elder Law:  Elder Law  Elder Law
Family Law:  Family Law  Family Law
Annual Meeting & Outing:  Annual Meeting & Outing  Annual Meeting & Outing
Probate Law:  Probate Law  Probate Law
Website/Publications:  Civil Law  Civil Law
Real Estate Law:  Real Estate Law  Real Estate Law
Scholarship:  Scholarship  Scholarship
YLS/Law Day:  YLS/Law Day  YLS/Law Day
CLE:  CLE  CLE
Barristers Ball:  Barristers Ball  Barristers Ball
Membership:  Membership  Membership
Associate Membership:  Associate Membership  Associate Membership
Please click here for a printable Waterbury Bar Association application/renewal form: New 2017-2018-WBA-application