First Name*
M.I.
Last Name*
Email*
Phone*
Fax
Firm*
Address*
P.O. Box
City*
State*
Zip Code*
Year Admitted to Practice
Area(s) of Practice* (select up to six) Alt. Dispute ResolutionCivil Defense LitigationCommercial LitigationConstruction LawCreditor's RightsEmployment LawFamily LawGovernment LiabilityGovernmental RelationsHealthcareIndian LawInsurance CoverageInsurance DefenseMedical MalpracticePersonal InjuryProduct Liability DefenseProfessional MalpracticeTort Liability
Organizational Memberships* (please respond to all questions) I am a member of the North Dakota Association for Justice ("NDAJ"): YesNo I am a member of the American Association for Justice ("AAJ"): YesNo
If you are a member of either NDAJ or AAJ, please explain why you believe you qualify for membership in NDDLA:
I am a member of the Defense Research Institute("DRI"): YesNo
Annual NDDLA Membership Dues $100 - New Member$100 - Associate Member$50 - Retired Member
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