Bar Licensure Employment Information Form

Bar Licensure Employment Information Form
Please provide your employment and professional details for bar licensure review.
Full Name
First NameLast Name
Email Address
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Current Address
Street Address
Street Address Line 2
CityState / ProvincePostal / Zip Code
Current Employer Name
Current Employer Address
Street Address
Street Address Line 2
CityState / ProvincePostal / Zip Code
Position/Title
Employment Start Date
MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Supervisor Name
First NameLast Name
Supervisor Email
example@example.com
Areas of Legal Practice (select all that apply)
Other
Provide details of previous legal employment (if any)
Professional References (at least one required)
Please upload your resume or curriculum vitae (CV)
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Applicant Signature
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