New Hampshire Municipal Lawyers Association
Meeting the Education, Communication & Service Needs of New Hampshire Municipal Lawyers
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Membership Application
Membership Application

2015-2016 Member Application Form/Renewal Invoice
Membership Year: 10-1-2015 to 9-30-2016

Instructions: New Members please complete parts 1 & 2; renewing members please complete only part 1. Return this form with your membership dues; see part 3.

Part 1. Information: to be completed for both new members & renewals.}
 
Name of firm or local government employer: ____________________________
Address:      ______________________________________
                   ______________________________________
                   ______________________________________
Primary Telephone:         (     ) ____________________

Names & email addresses & Bar ID #s of attorneys covered:; please type or print legibly. Attach separate sheet for additional attorneys, if needed.
Name                                                          Exact email address                                                              
 
_____________________________          __________________________      
                         
_____________________________          __________________________    
                            
 
______________________________          __________________________                                
 
Part 2. For New Member Applicants Only:
For law firms or individual attorneys who are not employed as legal counsel by a municipality, please describe your municipal practice and list representative clients:

______________________________________________________________________________

______________________________________________________________________________
 
Part 3 Dues Computation:
        Number of individual attorney memberships __ @ $25 each = $ _______
        Please return a check for correct amount with this form to:
          NHMLA, 414 East View Drive, Pembroke, NH 03275.
 
Thank you. Please contact Dan Crean @ 603-928-7760 or nhmlaadmin@comcast.net if you have any questions.

 

 

 



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