Membership Application

Select Membership:	General Membership $30 (first city or town attorney in each office) $10 (each additional city or town attorney in the office) Associate Membership $50 $20 (Retired/Low-Income Associate Member)
Name:	First: Initial: Last:
Title:
City/Town/Agency:
Adress:

City:
State:	Zip:
Phone:	( )
Fax:	( )
Email:
Select One:	City/Town Attorney Assistant City/Town Attorney