Firm Name:

Address 1:
Address 2:

City: State: Zip:

State Bar Number:

Business Phone:

Business Fax:

E-Mail:

Website:

Do you want your photo in the online member directory?
Yes, use my photo that is on file
Yes, I will send a file to GCBA
No, I do NOT want to publish a photo online

Additional Information

Areas of Practice

Birth Date:

Are you in active practice? yes no

Home Address:

City: State: Zip:

Home Phone

Spouse's Name

Education

Undergraduate:

Juris Doctorate:

Other Degrees:

If applying for a student membership:

School: Year:

Year of Admission to the State Bar of Michigan:

Membership to Other Bars (Please Name) ?

Enter Code

Please press the Submit Information button. On the next screens you will pick your membership type in our online store and can either purchase online or elect to be invoiced.