Title: Select Judge Professor Mr. Mrs. Ms.

Firm/Company/Agency:
Business Address: Suite:
City: State:
Zip (please include + 4 digits)
Business Telephone (include area code)
Business Fax # (include area code)

Home Address:
Home Telephone (include area code)
City: State:
Zip (please include + 4 digits)

Date of Birth (Required):

Preferred Mailing Address: Select Business Home
Preferred E-mail Address:

Primary Areas of Law Practice Emphasis:
(For full list of code descriptions click here.)

Select ADM ADO ADR AER ANT APP ARB BAN BFI BUS CAL CDN CIV CMM CMP CNL CNS COL COM CON COP COR CRI DEB DIS DOM EL-L EMP ENE ENT ENV EST ETH FAM FDA FIN FNP GEN GOV HOS HOU IMM INS INT INV IPL JUV LAB LEA LEG LIQ LIT LTL M&A MAL MAR MDA MED MHE MIL MUN NEG NPO PTC PBI PBL PBU PEN PLI PRO REA REG RET RRD RTD SCH SEC SET SPT SUB TAX TRA TRN TRU VIC WOR WRO WRT ZON Select ADM ADO ADR AER ANT APP ARB BAN BFI BUS CAL CDN CIV CMM CMP CNL CNS COL COM CON COP COR CRI DEB DIS DOM EL-L EMP ENE ENT ENV EST ETH FAM FDA FIN FNP GEN GOV HOS HOU IMM INS INT INV IPL JUV LAB LEA LEG LIQ LIT LTL M&A MAL MAR MDA MED MHE MIL MUN NEG NPO PTC PBI PBL PBU PEN PLI PRO REA REG RET RRD RTD SCH SEC SET SPT SUB TAX TRA TRN TRU VIC WOR WRO WRT ZON Select ADM ADO ADR AER ANT APP ARB BAN BFI BUS CAL CDN CIV CMM CMP CNL CNS COL COM CON COP COR CRI DEB DIS DOM EL-L EMP ENE ENT ENV EST ETH FAM FDA FIN FNP GEN GOV HOS HOU IMM INS INT INV IPL JUV LAB LEA LEG LIQ LIT LTL M&A MAL MAR MDA MED MHE MIL MUN NEG NPO PTC PBI PBL PBU PEN PLI PRO REA REG RET RRD RTD SCH SEC SET SPT SUB TAX TRA TRN TRU VIC WOR WRO WRT ZON

Complete the following as appropriate:
Date Admitted to The Missouri Bar (Required):
Missouri Bar #
Currently in good standing: Select Yes No

Have you ever been a member of The Bar Association of Metropolitan
St. Louis? Select Yes* No If yes, state when and see below:

*Reinstatement Fee: If your membership was terminated for nonpayment of dues, you will be assessed an extra fee of one-half of your current dues amount.

I am currently licensed in the following other State or Federal Bars (with date of admission and Bar IDs):

I am a full-time member of the following law school faculty:

I hereby certify that the foregoing information is true and complete. I have read and am familiar with the canons of ethics adopted by the Missouri Supreme Court (Rule 4), and I agree that if I am admitted as a member of this Association, I shall conduct myself in accordance therewith.

I ENCLOSE A CHECK MADE PAYABLE TO BAMSL FOR MY ANNUAL DUES IN THE AMOUNT OF $
PLEASE APPLY MY ANNUAL DUES PAYMENT TO MY Select Mastercard Visa
No. EXP.DATE
SIGNATURE

Yes, please send me/us a BAMSL Commerce Bank Visa Gold Membership Card for my/our use in obtaining services at the Association facilities and any other goods, or advances. I/we agree to be bound by the charge card agreement, as amended, which shall cover my/our account and that information on my/our credit performance may be exchanged with others who may properly receive information. A co-applicant is not necessary for BAMSL membership application and is optional for bank card issuance.
Yes, I would like to sign up for the optional Commerce Miles Frequent Flyer Program. ($35 annual enrollment fee)

Instructions for submitting form:
1.  Print this page
2.  Sign and date the application
3. Mail to: BAMSL, 720 Olive Street, Suite 2900
         St. Louis, MO 63101; Or Fax to...314-421-0013