Registration Form

Please provide the following information:

Name
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Work Phone
Home Phone
FAX
E-mail
Bar ID #

Check appropriate box:

MS Volunteer Lawyers Project Panel ($ 45.00 - Registration prior to August 1)
Non-MVLP Lawyers( $110.00 - Registration prior to August 1)
All Social Workers( $10.00 for SWU Hours)
Legal Services/AAA/UM Staff (No Charge)

Mailing fee before August 1 to: NMRLS, P.O. Box 767, Oxford, MS  38655
Paying fee at Conference (This option does not guarantee you a spot)