Registration Form

FREE LEGAL CLINIC

September 16, 2026
Frank B. Wise BLDG #3 Ethete Rd., Fort Washakie, WY Time: 10:00-2:00
Veteran
Senior
Native American
First Name
Middle Initial
Last Name
Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email Address
example@example.com
Appointment
Should be Empty: