Central Illinois Women's Bar Association
June 1, 2019-May 31, 2020 Membership Form
Address, City, State, Zip Code
Areas of Practice
Please mark the committee(s) you are interested in serving on:
Sojourn Shelter Fundraiser
Take Your Kid to Work Play Day Committee
Judicial Reception Committee
General CIWBA Member ($35.00)
Joint CIWBA and Government Bar Association (GBA) Member ($30.00) by checking this option, I certify that I have remitted payment for the 2018-2019 program
Assistant State's Attorney, Assistant Attorney General, or Public Defender Member ($25.00)
New Lawyer (0-3 years of practice) ($20.00)
Dues are due by June 1, 2019
Please make checks payable to Central Illinois Women's Bar Association or CIWBA. Please submit payment to Maureen Faller, Prairie State Bank and Trust, 3751 West Wabash, Springfield, IL 62711. **Late fee of $5.00 after July 1, 2019. Late fee of $10.00 after August 1, 2019. Late fee does not apply to first time members. ** By dating and submitting this form, I certify that I have remitted payment of dues to CIWBA.
Never submit passwords through Google Forms.
This form was created inside of CIWBA.
Terms of Service