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
Areas of Practice
Birth Date:
Are you in active practice? yes no
Home Address:
Home Phone
Spouse's Name
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) ?
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.