ONEIDA COUNTY BAR ASSOCIATION

258 Genesee Street, Suite 302

Utica, New York 13502

Tel: 315-724-4901 Fax: 315-724-6010

Membership Application

( The way you print your name is the way it will appear in our directory.)

Name:___________________________________________________________________

Address (Home):__________________________________________________________

Firm Name & Address:_____________________________________________________

_________________________________________________________________________

Telephone (Home):_____________(Business)__________________ Fax:_____________

Email____________________________________________________________________

Undergraduate:______________________________________ Year Graduated:_______

Graduate School:_____________________________________ Year Graduated:_______

Degree:__________________________________________________________________

Law School:_________________________________________  Year Graduated:_______

Honors, Awards & Other Activities:___________________________________________

_________________________________________________________________________

_________________________________________________________________________

Date Admitted to New York Bar:____________Dept:__________ (Month, Day and Year)

Date Admitted to other State Bars:____________________________________________

(Please Print out this form and mail it to OCBA.)