Application For Fellowship

Nominated by:*

Please enter the name of the member who has nominated you.

1. Applicant's Name*

2. Law Firm*

3. Business Address*

Street Address

Address Line 2

City

State

ZIP Code

4. Business Phone*

Fax

5. Email*

Enter Email

Confirm Email

Required Information

In answer to questions 6, 7, 8 and 9 you may elect to attach a curriculum vitae for expediency.

6. List all State and Federal Courts to which you are admitted to practice starting the year in which you were admitted:

7. List all State and National Trial Lawyer Associations in which you hold membership:

8. List all position(s) or office(s) which you have held in any bar or trial lawyer organizations:

9. Please list professional honors, appointments, achievements or other notable accomplishments:

By signature on this application, I do hereby certify that I am an active and full dues paying member of AAJ and its affiliated State Trial Lawyers Association. I hereby authorize STLA to verify that I hold these memberships prior to approving this application.

I further understand that I must continue to be a full and active dues paying member of both AAJ and its state affiliate, and that withdrawal of membership in either organization will automatically terminate my fellowship with the Southern Trial Lawyers Association.

Name*

Date*

To be considered:

INSERT TEXT HERE FOR PAYMENT TERMS AND BOARD MEMBER

Upload Curriculum Vitae (optional)

Application For Fellowship