DISABILITY AND ELDER LAW
ATTORNEYS ASSOCIATION, INC.
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MEMBERSHIP APPLICATION/RENEWAL (Please Type or Print)
DATE: ____________________________________________________________
NAME: ____________________________________________________________
FIRM NAME: _______________________________________________________
MAILING ADDRESS: __________________________________________________
___________________________________________________________________
OFFICE TELEPHONE: _________________________________________________
FACSIMILE: _________________________________________________________
E-MAIL: ____________________________________________________________
WEBSITE: ___________________________________________________________
BAR NUMBER: ______________________________________________________
REFERRED BY: _______________________________________________________
(How did you hear about DELAA)
Annual dues are $50.00 ($25 for students) and the monthly luncheon is $30.00 for members ($37.00 for non-members and $25 for students with first meeting free), payable at the door, which includes 1 hour of MCLE. You will receive an e-mail notification of the regularly scheduled monthly luncheon. Please return this completed application form with your check made payable to DELAA for annual dues in the amount of $50.00 to:
Mail to:
Lisa Wilson
Hayes & Wilson, PLLC
2525 North Loop West, Ste. 125
Houston, Texas 77008
(713) 880-3939 telephone
(713) 880-9990 facsimile