NAME:

EMAIL ADDRESS:

LAW LIBRARY I.D. NUMBER

TELEPHONE NUMBER:

YEAR CALLED TO THE BAR:

YEAR CALLED TO INNER BAR (IF APPLICABLE):

CIRCUIT MEMBERSHIP (PLEASE INDICATE THE GEOGRAPHICAL AREAS IN WHICH YOU PRACTICE):

LIST OF SPECIALISMS/AREAS OF WORK (UP TO FIVE), INDICATING THE PERCENTAGE OF TIME SPENT ON EACH:

ANY ADDITIONAL INFORMATION (OPTIONAL):