ESRBA Membership Renewal

Name*

First NameLast Name

Firm Information / Mailing Address

Firm Name

Street Address

CityState / Province

Postal / Zip Code

Phone Number

Email*

email address

Bar Number

Date Admitted to the Florida Bar

Date

Bar Admissions in another State(s)

Other State(s) admitted, date, bar number (If applicable)

Education Information

Universities / Colleges Attended, Degrees Obtained, Dates of Graduation

Practice Area(s) of Interest or Specialization (if applicable)

Area(s) of Interest

Want to learn more about our exciting new initiatives?

Membership Renewal Options

Join the ESRBA

Private Attorney

$200.00

	Quantity	Price
Private Attorney (Over 5 Years)		$200.00
Private Attorney (Under 5 Years)		$135.00

Government Attorney

$180.00

	Quantity	Price
10 or More Years		$180.00
5 to 9 Years		$85.00
Less than 5 Years ( Must add YLD Membership)		$0.00

Inactive MemberInactive Member (must have inactive status with the Florida Bar) shall be exempt from payment of dues and shall not be entitled to hold office or vote, but may otherwise be accorded all privileges of an active Member of the Association.

$ Free

Student / Associate MemberFor our legal community members who are not yet eligible to practice law in Florida.

$90.00

Enhance your Membership

Young Lawyer's Division

$40.00

	Quantity	Price
Private Attorney		$40.00
Government Attorney		$20.00

Lawyer Referral ServiceContact Us to update your areas of practice. You agree to remit to ESRBA a 10% Commission on fees from LRS cases within 30 days of receipt.

$150.00 Quantity

Premium Profile Enhance your Profile Listing in our Online Membership Directory. Add your bio, social media links and your area(s) of practice to your profile, and have it featured on our homepage.

$100.00

	Quantity	Price
Premium Profile (includes 2 areas of practice)		$100.00
Each additional practice area		$50.00

Support the ESRBA Foundation

$30.00

ID Badge*Needs enrollment form and photo ID* Will work for Santa Rosa and Escambia Courthouses.

$50.00

Total

$0.00

Credit Card

First Name

Last Name

Credit Card Number

Security Code

Expiration Month

Expiration Year

Billing Address

Street Address

Street Address Line 2

City

State / Province

Postal / Zip Code

Country

ESRBA Membership Application