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May 15, 2008 - search this site

Contact Information:
Your Bar Number:*

Please type full name (as it currently appears in our records, name change is below)
First name*
Middle initial
Last name*
Firm Name:

Name Change:
New First Name
New Middle Initial
New Last Name

Mailing address:
Street address
Address (cont.)
City
State/Province
Zip+4/Postal code
County
Telephone: (xxx-xxx-xxxx)
Fax: (xxx-xxx-xxxx)
Email address:
Effective date: (mm/dd/yyyy)

Privacy Options:

These options will only affect the "Member Finder" on MyAZBar.org and the "Find a Lawyer" function on AZBar.org. These options DO NOT affect the annual membership directory.
Publish my Address No     Yes
Publish my phone number: No     Yes
Publish my fax number: No     Yes
Publish my email address: No     Yes

Select up to 3 practice areas from the following menus:

Important: The current areas of practice found on your record will be deleted and replaced with the information you submit on this form.
It is very important that you provide new information for your record. If you do not provide us with new areas of practice, your record will contain no information.

Insurance Compliance:

Note: Private practice excludes government lawyers, in-house counsel, judges and legal services lawyers.

As of 1/1/08, I am an "active" member in private practice:

Yes, I am an "active" member in private practice
No


When you answer "yes" to the above question, you must also answer the following question.

I am currently covered by professional liability insurance:

Yes
No

(Rule 32 (c) 11 requires that you notify the State Bar of Arizona in writing within 30 days if your professional liability insurance lapses, is no longer in effect, or terminates for any reason.)

Select Ethnicity:

Note: The State Bar asks for your help in completing the full picture of our membership. That will allow us to serve your needs better and to track our changing demographics. Providing this information is strictly voluntary.

Select Language:

Important: With some browsers you must hold down CTRL or SHIFT while selecting to be able to select more than one language from the menu.

Dual Jurisdiction:

Note: If you have a dual Jurisdiction in another state, please provide the year admitted in Special Instructions.

Type in any special instructions:

Please be aware that your address, as you have provided, will become public information displayed on this website.

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