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Tompkins County Bar Association Application Form
Fields in red are required!
First Name:
Last Name:
Date Of Birth: (xx-xx-xxxx)
Residence Address:
City:
State:
Zip:
Phone:
Email:
Personal Information:
Law Firm Information:
Business Name:
Website:
Email:
Business Address:
City:
State:
Zip:
Phone:
Fax:
Education:
Pre-Law: (College)
Degree:
Professional: (other degrees)
Degree:
Original Admission To Bar:
Date:
Other states or foreign countries where you can legally practice:
Have you ever been disbarred or the subject of a disciplinary proceeding?
If Yes, please give details:
 
Enter Code: