legal malpractice central florida

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Shared by: Katy Perry
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Orange County Bar Association 2008-2009 MEMBERSHIP APPLICATION Thank you for your interest in becoming a member of the OCBA. As a condition of membership, Regular and Government attorneys are required to accept two (2) pro bono cases per year from the Legal Aid Society or pay a fee in lieu thereof. Please complete at least two address blocks and check only one of the blocks below as your Preferred Mailing Address. Your Preferred Mailing Address will be used for all OCBA mailings.* Membership Types Regular: attorney admitted in good standing to Florida Bar; resides in or practices at least part time in Orange County. Fee: $100; includes complimentary luncheons. Government: attorney admitted in good standing to Florida Bar; resides in or practices at least part time in Orange County and is employed by government. Fee: $100; includes complimentary luncheons. Judicial: Judge. Fee: $0; includes complimentary luncheons. Honorary: by invitation. Fee: $0; includes complimentary luncheons. Associate: retired jurist or OCBA member over age 65; or member of Florida Bar not actively practicing in Orange, Seminole, or Osceola counties; or attorney not admitted to Florida Bar but admitted in good standing to a practice in another state. Fee: $50. Associate: with luncheons. Fee: $100. Affiliate: paralegal; legal assistant; law office administrator; law librarian; international associate; or criminal justice. Fee: $50. Affiliate: with luncheons. Fee: $100. Law Student: enrolled in law school. Fee: $25. Law Student: with luncheons. Fee: $75. Paralegal Student: enrolled in paralegal courses. Fee: $25. Paralegal Student: with luncheons. Fee: $75. First Name Business Address (required) Firm Name: Firm Street Address: M/I Last Name ________________________________________________________________ ________________________________________________________________ Firm City / State / Zip: ________________________________________________________________ Firm Phone / Fax: E-mail Address: Website / URL: ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ Personal Address (optional) Street Address: City / State / Zip: Phone / Fax: Personal E-mail: ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ P.O. Box (optional) P.O. Box: City / State / Zip: ________________________________________________________________ ________________________________________________________________ Membership Directory Preference Photo: You must e-mail a current digital photo to susanl@ocbanet.org. Please save your jpg using your last name, first name and middle initial. Please also identify your name in the subject line of the e-mail. Your name, firm name, firm address, firm phone and fax, e-mail address, and membership photo (if available) will be published in the Membership Directory. Dues: $ ____________ Please do not include my E-mail address in the Membership Directory. Optional: Online Lawyer-to-Lawyer Network Private Statistical Information (required; will be kept confidential) Date of birth: ______________________________(dd/mm/yyyy) Gender: Ethnicity: Male Asian Female American Indian or Alaska Native Black or African American Hispanic or Latino/a (Fee: $50.00.) $ ____________ TOTAL: $ ____________ Native Hawaiian or Other Pacific Islander White Complete this form and mail with one check made payable to the Orange County Bar Association to: Other _________________________________________________________ Law School ____________________________________________ Year Graduated _______________ Florida Bar # ___________________________________________ mm/dd/yy ____________________ Licensure in other state: _________________________________ Bar # ________________________ Orange County Bar Association 880 N. Orange Avenue Orlando, FL 32801 407-422-4551 PLEASE COMPLETE PAGE 2 Thank you for providing the information requested below. It will be used by the OCBA to inform you of seminars, committee meetings, activities and other events. You will not be charged a fee for providing this information. To have your practice areas, board certifications and other information published online and in the Membership Directory, you may purchase the optional Online Lawyer-to-Lawyer Referral Network package offered by the OCBA in partnership with Browder Printing Technologies, Inc. (Fee: $50.00. See enclosed letter and flyer.) Other Bars & Organizations OCBA Committees & Sections Appellate Bankruptcy Business Community Service Construction Criminal Diversity Elder Entertainment Estate, Guardianship, Trust Family In-House Counsel Insurance Intellectual Property International Please check those to which you belong. Please check those to which you belong or would like to belong. American Bar Association Caribbean Bar Association - Central Florida Chapter Central Florida Bankruptcy Law Association Central Florida Association of Criminal Defense Lawyers Central Florida Association for Women Lawyers Central Florida Family Law American Inn of Court Central Florida Gay & Lesbian Law Association Central Florida Paralegal Association Federal Bar Association Federalist Society First Central Florida Inn of Court Hispanic Bar Association of Central Florida Orange County Association of Legal Support Specialists Paul C. Perkins Bar Association FLABOTA (American Board of Trial Advocates) - Central Florida Judicial Relations Labor / Employment Law Week Member Benefits Paralegal Professionalism Real Property Social Committee Social Security Solo & Small Firm Tax Law Website Workers’ Compensation Young Lawyers Section Practice Areas & Board Certification Please select up to five (5) practice areas and any board certifications you hold. Employment / Labor Practice Areas Entertainment / Sports Environmental Administrative Family / Marital Admiralty / Maritime Finance / Bond Agricultural First Amendment Antitrust / Trade Regulation Government Appellate Practice - Civil Health Appellate Practice - Criminal Immigration Arbitration Insurance Defense Aviation / Aerospace Insurance Coverage Disputes Banking Intellectual Property Bankruptcy International Bar Grievance / JOC Internet Business Juvenile Delinquency Civil Rights Juvenile Dependency Civil Litigation Legal Malpractice Class Actions Media Commercial Litigation Mediation Communications Medical Malpractice Constitutional Mergers / Acquisitions Construction Military Contracts Natural Resources Corporate Nursing Homes Criminal Defense PI / Wrongful Death Debtor / Creditor Post Conviction Litigation DUI Defense / Criminal Traffic Probate / Estates Education Products Liability Elder Professional Negligence Election / Campaign / Political Public Utilities Eminent Domain Real Estate Employee Benefits / ERISA I attest that the information given above is true and accurate. Signature_____________________________________________________ Securities Social Security Disability Taxation Transactional Wills / Trusts Workers' Compensation Zoning / Planning / Land Use Board Certifications Admiralty / Maritime Antitrust / Trade Regulation Appellate Aviation Business Litigation City / County / Local Government Civil Trial Construction Criminal Elder Health Immigration / Naturalization Intellectual Property International Labor / Employment Marital / Family Real Estate State / Fed Gov't & Admin Practice Tax Wills / Trusts / Estates Workers’ Compensation Date _________________ Questions? Please contact OCBA Membership at 407-422-4551 or susanl@ocbanet.org. Please complete form and mail with check made payable to OCBA to: Orange County Bar Association, 880 N. Orange Ave., Orlando, FL 32801.

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