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Defense TrialCounsel of West Virginia
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Residence Address


Business Address


Degrees held and schools awarding same with year of graduation


Name of law firm or law office at which you are employed and the number of years you have been employed by the same


Total number of years you have been employed as a Legal Assistant/ Paralegal


Do you have an associate membership or any other type of membership with the American Trial Lawyers Association, the West Virginia Trial Lawyers Association, or any similar organization? If so, list the names of such organizations


The name and business address of the member of the Defense Trial Counsel of West Virginia who is sponsoring your application


The member of the firm or office at which you are employed who is a member of the Defense Trial Counsel of West Virginia


I understand that the annual dues for Legal Assistant members is $15.00 for assistants with less than five years of membership in the Association, and $25.00 for assistants with more than five years of membership in the Association


If accepted as a member, I agree to abide by the Charter, Articles of Incorporation, and By-Laws of this Association

Date


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