NCWBA 2023 Membership Form Please enable JavaScript in your browser to complete this form.Organization Name *Organization Acronym (if any -- e.g., "NCWBA")Mailing Address *Address Line 1Address Line 2CityState / Province / RegionPostal CodeCountryCountryUnited States of AmericaCanadaAfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBolivia (Plurinational State of)Bosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongoCongo (Democratic Republic of the)Cook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Kingdom of)EthiopiaFalkland Islands (Malvinas)Faroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHondurasHong KongHungaryIcelandIndiaIndonesiaIran (Islamic Republic of)IraqIreland (Republic of)Isle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea (Democratic People's Republic of)Korea (Republic of)KosovoKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesia (Federated States of)Moldova (Republic of)MonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth Macedonia (Republic of)Northern Mariana IslandsNorwayOmanPakistanPalauPalestine (State of)PanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint Martin (French part)Saint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint Maarten (Dutch part)SlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyrian Arab RepublicTaiwan, Province of ChinaTajikistanTanzania (United Republic of)ThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited Kingdom of Great Britain and Northern IrelandUnited States Minor Outlying IslandsUruguayUzbekistanVanuatuVatican City StateVenezuela (Bolivarian Republic of)VietnamVirgin Islands (British)Virgin Islands (U.S.)Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland IslandsCountryIs the organization's street address different? *YesNoStreet AddressAddress Line 1Address Line 2CityState / Province / RegionPostal CodeCountry (copy)CountryUnited States of AmericaCanadaAfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBolivia (Plurinational State of)Bosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongoCongo (Democratic Republic of the)Cook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Kingdom of)EthiopiaFalkland Islands (Malvinas)Faroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHondurasHong KongHungaryIcelandIndiaIndonesiaIran (Islamic Republic of)IraqIreland (Republic of)Isle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea (Democratic People's Republic of)Korea (Republic of)KosovoKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesia (Federated States of)Moldova (Republic of)MonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth Macedonia (Republic of)Northern Mariana IslandsNorwayOmanPakistanPalauPalestine (State of)PanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint Martin (French part)Saint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint Maarten (Dutch part)SlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyrian Arab RepublicTaiwan, Province of ChinaTajikistanTanzania (United Republic of)ThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited Kingdom of Great Britain and Northern IrelandUnited States Minor Outlying IslandsUruguayUzbekistanVanuatuVatican City StateVenezuela (Bolivarian Republic of)VietnamVirgin Islands (British)Virgin Islands (U.S.)Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland IslandsCountryEmail *Phone *Website / URLSocial Media Links (e.g. Instagram, Twitter, LinkedIn, Facebook, etc.)Organization Information Membership Category *Women's Legal OrganizationCorporate Affinity GroupLaw Firm Affinity GroupWomen's Law Student AssociationTotal Number Of Members (as of the end of last fiscal year; If organization a charity with no members, enter 0.) *Officer Terms - Start Month/End Month *Financial Fiscal Year - Start Date/End Date *Organization Type *501(c)(6)501(c)(4)501(c)(3)Law School OrganizationOtherOther Organization Type (please describe)Leadership InformationPresident/Chair Name *FirstLastTitlePresident/Chair Email *President/Chair Work PhonePresident/Chair Alternative PhoneAdd to Women Bar Leaders Listserv?YesNoOur "Women Bar Leaders Listserv" provides a way for current and former bar leaders to exchange ideas and look for professional referrals in other jurisdictions. Our Women Bar Leaders listserv is NOT used for marketing or distribution. President-Elect/Chair-Elect or Alternative Leader Name *FirstLastPresident-Elect/Chair-Elect or Alternative Leader TitlePresident-Elect/Chair-Elect or Alternative Leader Email *President-Elect/Chair-Elect or Alternative Leader Work PhonePresident-Elect/Chair-Elect or Alternative Leader Alternative PhoneAdd to Women Bar Leaders Listserv?YesNoOur "Women Bar Leaders Listserv" provides a way for current and former bar leaders to exchange ideas and look for professional referrals in other jurisdictions. Our Women Bar Leaders listserv is NOT used for marketing or distribution. Does your organization have an Executive Director or Administrator? *YesNoExecutive Director FirstLastExecutive Director TitleExecutive Director EmailExecutive Director Work PhoneExecutive Director Alternative PhoneAdd to Women Bar Leaders Listserv?YesNoOur "Women Bar Leaders Listserv" provides a way for current and former bar leaders to exchange ideas and look for professional referrals in other jurisdictions. Our Women Bar Leaders listserv is NOT used for marketing or distribution. Do you have an additional contact you would like to add?YesNoAdditional Contact Name *FirstLastAdditional Contact TitleAdditional Contact Email *Additional Contact Work PhoneAdditional Contact Alternative PhoneAdd to Women Bar Leaders Listserv? (copy)YesNoOur "Women Bar Leaders Listserv" provides a way for current and former bar leaders to exchange ideas and look for professional referrals in other jurisdictions. Our Women Bar Leaders listserv is NOT used for marketing or distribution. Faculty Advisor or other administrative contact *FirstLastFaculty Advisor or other administrative contact Email *Faculty Advisor or other administrative contact PhoneAdd to Women Bar Leaders Listserv?YesNoOur "Women Bar Leaders Listserv" provides a way for current and former bar leaders to exchange ideas and look for professional referrals in other jurisdictions. Our Women Bar Leaders listserv is NOT used for marketing or distribution. Membership DuesMembership Rates *100 members or fewer - $ 90.00101-500 members - $ 175.00501-1,000 members - $ 300.00Over 1,000 members - $ 375.00Women's Law Student Association - $ 0.00Please select the category your organization falls under to determine the amount of dues owed.Total$ 0.00Payment Options *Pay by Credit/Debit Card via PaypalPay By CheckIf paying by check, please mail to NCWBA P.O. Box 260721, Boston, MA 02126.Please provide any other information that you may think would be helpful.Before you click on "SUBMIT," you may want to print this form for your records.Submit
