Name
*
First Name
Last Name
Email
*
Phone
*
(###)
###
####
Name of Firm/Employer
Business Address
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Business Phone
(###)
###
####
Home Address
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Home Phone
(###)
###
####
Online Directory Publication Options
*
Areas and/or Types of Practice
State Bar Number
Bar License Date
Board Certification and Specialization
Law School Graduation Year
Law School Attended
Do you certify that the information provided in your BCWB Profile is current and accurate?
This question is required for all attorneys seeking inclusion in the BCWB Referral Guide
Committee Participation
We encourage our members to consider serving on one or more of our committees. Please indicate below which committees you might
be interested in serving. Your indication of interest is not a commitment to serve; rather, the co-chairs of the committees will send you
information when a need for assistance arises.
Event Sponsorship
If you are interested in sponsoring a BCWB event, please select from the list below and you will be
contacted in advance of the event(s) to discuss sponsorship opportunities.
Membership Level
*
Please select the membership level you would like to join.
