Paul C. Perkins Bar Association Membership Application 2018-2019
Membership Application for June 1, 2018 through May 31, 2019
Email address *
Name *
(First Name, Middle Initial/Name, Last Name)
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Florida Bar Number
Attorneys Only
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Bar Admission Date
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Employer Name
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Current Position/Title
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Employer Mailing Address
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Telephone Number
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Undergraduate School
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Law School
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Area(s) of Practice
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Board Certifications
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PLEASE CHECK ONE *
Required
ANNUAL DUES - Type of Membership *
PCPBA's membership year runs from June 1st to May 31st each year. PCPBA accepts membership applications on a rolling basis throughout the year, but membership dues are not prorated. (Please check one)
Required
I would like to participate with the following committees and/or programs:
"We Make a Living by What We Get - We Make a Life by What We Give." (Select any and all that apply)
PAYMENT TYPE *
If paying by check or cash, please make the check payable to Paul C. Perkins Bar Association and mail to: Paul C. Perkins Bar Association, P.O. Box 1589, Orlando, Florida 32802-0866.
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