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             HANCOCK COUNTY BAR ASSOCIATION

                   MEMBERSHIP REGISTRATION

 

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Please Fill out the form below to Register for Membership for the Hancock County Bar.  Annual Membership Fees are $50.00
 

NOTE: Items in BLUE are required for the form.
FIRST NAME
LAST NAME
COMPANY
ADDRESS
SUITE, BLDG, APT
CITY
STATE
ZIP CODE
E-MAIL ADDRESS
PHONE NUMBER
FAX NUMBER

PLEASE INCLUDE MY LISTING ON THE

ASSOCIATION MEMBERSHIP WEBSITE

(http://www.hancockbar.org/members.html)

 
I wish to receive referrals from the Hancock County Bar Association in the following practice areas:
   

To pay by check, please print this completed form and and mail to:

 

Hancock County Bar Association

c/o Overhauser & Lindman, LLC

740 W. Green Meadows Drive, Ste. 300

Greenfield, IN 46140

 

Please make all check payable to the Hancock County Bar Association

 

 Name of Cardholder

           Card Number

                 Exp. Date

               Card Type