Catholic Law Judges Wall Application Form

Catholic Law Judges Wall Application Form

Please fill in the form below to have your name added to the Judges Wall.
Full Name*

First NameLast Name
Home Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Preferred Phone Number*

Area CodePhone Number
Preferred E-mail*
Class Year
Year of Appointment
Name of Court/Jurisdiction
Judicial Title
Name as it should appear on the plaque: (Example: John Q. Public '70 or John Quincy Public '70)
Please verify that you are human*
Should be Empty: