Training Registration Form
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Capital Habeas Certification Training
Hosted by: Virginia Indigent Defense Commission
Location: VIDC, 1604 Santa Rosa Road, Suite 200, Richmond, VA 23229

Date: Friday, July 26, 2019
Time: 9:00 AM - 4:30 PM (Registration Check In @ 8:30 AM)
CLE: 6.0 hours (1.5 ethics) expected
Cost: $0.00

FIRST NAME *
Your answer
MIDDLE INITIAL *
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LAST NAME *
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VIRGINIA STATE BAR NUMBER *
Note: Virginia State Bar number is required to take the VIDC Certification Training.
Your answer
NUMBER OF YEARS LICENSED TO PRACTICE LAW IN VIRGINIA *
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FIRM NAME *
*Please answer "N/A' if this does not apply
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ADDRESS *
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CITY, STATE & ZIP CODE *
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PHONE *
*Please include area code
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EMAIL ADDRESS *
A registration confirmation and training materials will be emailed to the address you provide. **PLEASE REVIEW YOUR RESPONSE FOR ACCURACY**
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CONFIRM YOUR INTENDED CERTIFICATION TYPE *
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