AFFILIATE PROFILE FORM
American Bar Association Young Lawyers Division

Your relationship with us is important. To ensure that your young bar organization remains active with the ABA YLD and continues to receive the many benefits of being an affiliate, please assist us by updating any changes affecting your bar’s profile.

GENERAL INFORMATION

Name of Affiliate Organization

Address1
Address2

City		State		Zip
Phone		Fax

Staff Contact:
First Name		Last Name

Title
Email Address
Number of Supporting Staff:
Organization’s Web Site Address?

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ORGANIZATION PROFILE

Choose one of the following that best describes your organization:    State Affiliate    International Affiliate    Local Affiliate    Specialty Affiliate    Other (Please Describe):

Is your organization affiliated with a senior bar? Yes   No

IF YES: Is membership in your organization automatic? Yes   No

Number of Young Lawyers in your organization:

How does your organization define its Young Lawyer members? Age   Yrs of Practice   Both

Please Explain:

If a state organization, are you a mandatory or   voluntary bar?

What is the overall budget for your organization?

Does your young lawyer organization charge dues? Yes   No

Does your organization have substantive committees? Yes   No

Is your organization affiliated with other bar associations? Yes   No

IF YES: Please list

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CURRENT FISCAL YEAR OFFICERS

Date president-elect listed below takes office as president:
Chair/President

First Name

Initial

Last Name

Leadership Position
Firm Name
Address1
Address2

City		State		Zip
Phone		Fax

Email Address

Is he/she a member of the American Bar Association? Yes   No

IF YES, please provide ABA Membership ID#

Chair-Elect/President-Elect or Vice Chair:

First Name

Initial

Last Name

Leadership Position
Firm Name
Address1
Address2

City		State		Zip
Phone		Fax

Email Address

Is he/she a member of the American Bar Association? Yes   No

IF YES, please provide ABA Membership ID#

Name of person completing form

Email Address

By clicking ‘Submit’ I am granting or have been given permission to provide this contact information so that I or the contact provided may receive communications from the ABA YLD.

For assistance, please contact the ABA YLD at 312-988-5611 or via email at yld@staff.abanet.org.