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  El Paso County Bar Association
19 North Tejon, Suite 200
Colorado Springs, CO 80903

Telephone: (719) 473-9700
Fax: (719) 473-0604

 
Membership Application
El Paso County Bar Association
Full Name
Date of Admission to Colorado Bar
Colo Att. Reg #
   
Firm Association
Business Address
City
State
Zip
Phone
Fax
Email
   
Residence Address
City
State
Zip
Home Phone
   
Date and Place of Birth
   
Name of Spouse
   
Degrees, including J.D.
   
Other states or Jurisdictions in which you are licensed (include date of admisssion)
   
Previous legal experience or employment
Type of Membership
   
I hereby certify that the information on this form is true and accurate. By selecting the checkbox on this web based Membership application, I hereby authorize the release of information from the Attorney Regulation Committee of the State of Colorado or a comparable body of any other State regarding any public discplinary action that has been taken against me, or any grievance proceeding, which is pending. I authorize the release of any records relating to any past criminal acts.

PRIVACY OF INFORMATION ON MEMBERSHIP APPLICATIONS: It shall be the policy of the El Paso County Bar Association that information given on the membership application shall be kept confidential except for the following information which can be released upon request: (1) Name, (2) Business address, (3) Business Phone, (4) Date of admission to Colorado Bar.