Membership Certificate Order Form A membership certificate suitable for

Membership Certificate Order Form A membership certificate suitable for framing may be purchased for $25. The certificate measures approximately 13-1/2" x 16-1/2" and includes your name, bar number and date of admission. Certificates are hand-lettered, so please allow six to eight weeks for delivery. To order a certificate, please send this form along with a check for $25 (payable to the Washington State Supreme Court) and a photocopy of your bar card to: Washington State Supreme Court PO Box 40929 Olympia, WA 98504-0929 Request for Membership Certificate Name (please print) ________________________________________________________________________________ Bar Number (required) ______________________________________________________________________________ Certificates are shipped UPS Ship to the following address (no PO boxes) Name ________________________________________________________________________________ Address ______________________________________________________________________________ City/State/Zip _________________________________________________________________________ Telephone Number (_________) __________________________________________________________ 0601

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