PaTLA: fostering public awareness and understanding of the role of the trial lawyer in the administration of justice.

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Home Home Join PaTLA 2004 New Member Application Dues for new members are only $99. Your annual dues will provide a variety of benefits, including a 1-year subscription to PaTLA News , valued at $50. Dues are valid to 12/31/2004. Use this form to become a new member. To renew your current membership dues, please go to Renew. To add a section to your existing membership, go to Sections Prefix None Mr. Dr. Hon. Mr. Miss Mrs.Ms. Rev. *First Name   Middle Initial or Name   *Last Name   Informal(Bob)   Suffix None II III IV Jr. Sr. Designation(Esq.)       *Firm *Street Address, Suite # Building Name, P.O. Box   *City *State Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington Washington DC West Virgina Wisconsin Wyoming   *Zip Code   PA Supreme Court ID No.(required for Attorneys) Year Admitted to Practice Admitted in 1930 Admitted in 1931 Admitted in 1932 Admitted in 1933 Admitted in 1934 Admitted in 1935 Admitted in 1936 Admitted in 1937 Admitted in 1938 Admitted in 1939 Admitted in 1940 Admitted in 1941 Admitted in 1942 Admitted in 1943 Admitted in 1944 Admitted in 1945 Admitted in 1946 Admitted in 1947 Admitted in 1948 Admitted in 1949 Admitted in 1950 Admitted in 1951 Admitted in 1952 Admitted in 1953 Admitted in 1954 Admitted in 1955 Admitted in 1956 Admitted in 1957 Admitted in 1958 Admitted in 1959 Admitted in 1960 Admitted in 1961 Admitted in 1962 Admitted in 1963 Admitted in 1964 Admitted in 1965 Admitted in 1966 Admitted in 1967 Admitted in 1968 Admitted in 1969 Admitted in 1970 Admitted in 1971 Admitted in 1972 Admitted in 1973 Admitted in 1974 Admitted in 1975 Admitted in 1976 Admitted in 1977 Admitted in 1978 Admitted in 1979 Admitted in 1980 Admitted in 1981 Admitted in 1982 Admitted in 1983 Admitted in 1984 Admitted in 1985 Admitted in 1986 Admitted in 1987 Admitted in 1988 Admitted in 1989 Admitted in 1990 Admitted in 1991 Admitted in 1992 Admitted in 1993 Admitted in 1994 Admitted in 1995 Admitted in 1996 Admitted in 1997 Admitted in 1998 Admitted in 1999 Admitted in 2000 Admitted in 2001 Admitted in 2002 Admitted in 2003 Admitted in 2004   *County (If outside of PA, select Out of State) Out of State Adams Allegheny Armstrong Beaver Bedford Berks Blair Bradford Bucks Butler Cambria Cameron Carbon Centre Chester Clarion Clearfield Clinton Columbia Crawford Cumberland Dauphin Delaware Elk Erie Fayette Forest Franklin Fulton Greene Huntingdon Indiana Jefferson Juniata Lackawanna Lancaster Lawrence Lebanon Lehigh Luzerne Lycoming McKean Mercer Mifflin Monroe Montgomery Montour Northampton Northumberland Perry Philadelphia Pike Potter Schuylkill Snyder Somerset Sullivan Susquehanna Tioga Union Venango Warren Washington Wayne Westmoreland Wyoming York   Phone# Fax#   *E-Mail ([email protected]) Your home address will be used to identify legislative district numbers and will only be used by PaTLA. By policy of the PaTLA Executive Committee, we will not sell residential address data about our members. Home Address Home City State Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington Washington DC West Virgina Wisconsin Wyoming Zip Code PaTLA Web Site To access the PaTLA web site, enter a login ID and a password. If you are an attorney in Pa., you are required to use your Supreme Court ID for your login ID. The password must be at least 6 characters in length and must contain both alphabetical and numerical characters. Please remember to write these down before clicking 'Sign - Up' *Login ID *Password Areas of Practice Automobile Bad Faith Civil Rights Commercial Criminal Employment Family Medical Malpractice Premises Liability Products Liability Toxic Torts Workers' Comp     Represent Plaintiffs Defendants Communication Preference Email Fax Mail No Preference     Firm Size 1 to 2 Employees 3 to 9 Employees 10 or more employees Gender (Optional) Male Female     Member Categories New Members - $99 1994 or Earlier - $350 1995 - 1998 - $325 1999 - 2001 - $195 2002 - $100 New Bar Admittee - $50 Champion of Justice - $1,500 President's Club - $1,000 Sustaining Member - $500 Out of State Attorney - $125 Law School Professor/Public Interest Attorney- $125 Judicial Law Clerk (full-time) - $95 (Please provide the name of the judge in the 'Firm' field above) Paralegal (full-time) - $95 Law Student (full-time) - $35 Sections & E-Mail Listservs(Additional) more info... Automobile Insurance Law $45 Fire/Property Insurance Litigation $25 Insurance Bad Faith $50 Medical Malpractice $100 Workers' Compensation $35 New Lawyers FREE (members in practice less than 10 years) E-Mail Listserv: Add me to any Section Listserv for which i am eligible. Payment Method Credit Card Type American Express Discover Card Master Card VISA Card Name on credit card Credit Card Number Credit Card Expiry Date January February March April May June July August September October November December 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 Checks: Make payable to PaTLA Please print this form and mail to PaTLA at the address below. Amount Payable:   $             Important: Your dues payment will not be deductible as a charitable contribution, but will, in general, be deductible for most members as a business expense, exception to the extent provided in the next sentence. Pursuant to the Revenue Reconciliation Act of 1993, Pennsylvania Trial Lawyers Association estimates that 12 percent of your dues payment will not be deductible as an ordinary and necessary business expense because of PaTLA's lobbying activities on behalf of its members. Questions about this form? Questions about PaTLA membership? Please call PaTLA at (215) 546-6451 or email [email protected]