Membership Registration and Pay Dues

I hereby submit my application for membership in the Lawyer-Pilots Bar Association and pay herewith the sum indicated below to cover the payment of dues to to cover the payment of dues through the end of the membership year,*** which includes a subscription to the LPBA Journal. I do agree to abide by the by-laws and rules of the Association.

Last Name*

First Name*

Office Phone*

Email*

Method of Payment*

The LPBA is changing its membership year to coincide with the calendar year. If you are a current member, we ask that you pay your dues through the end of 2013. Just select the appropriate membership option below for the membership type you desire. If you are paying by check, multiply the appropriate membership fee by 1.5 if you are paying through 2013; if you are paying for the remainder of 2012, multiply the membership fee by 0.5 and remit a check in that amount. If you are paying by credit card, Karen Griggs will contact you to determine how your credit card should be charged.

New member

Existing member

	Membership Type
	Sustaining Member	$250 – Upgrade any of the below membership categories to become a Sustaining Member and get special recognition throughout the membership year. Click here for more details. Same voting privileges as underlying membership.
	Voting Member	$119 – Membership available to all persons duly licensed to practice law and who possess or have held a airman's certificate for piloting of aircraft (Lawyer / Pilot)
	Non-Voting Member	$119 – Membership available to all persons duly licensed to practice law and who have an interest in aviation safety and aviation law. (Lawyer / Non-Pilot)
	Student Member	$49 – Membership available to students enrolled in and currently attending a law school who have demonstrated an interest in aviation. Non-Voting. (Student / Pilot).** I am attending:
	Associate	$119 – Available to all persons who have an interest in aviation safety or aviation law. Non-Voting.

For Your Membership Record – Please Update The Information Below If You Have Any Changes

Firm Name

Office Address

Cell Phone

Fax

Residence Phone

Spouse Name

Year Admitted to Bar

Bar Memberships

Areas of Practice

Airman Ratings

Total Time

Airplane Owned or Usually Operated

N Number

Referred By

*Required fields

If you chose to pay with credit card: the payment will be processed securely through usaepay or paypal.

If you are paying with auto-renewal the dues will be auto renewed unless the member opts out.

Membership Registration and Pay Dues

For Your Membership Record – Please Update The Information Below If You Have Any Changes

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