Orange County Patent Law Association
P.O. Box 7632
Newport Beach, CA 92658

2009 OCPLA MEMBERSHIP APPLICATION/RENEWAL FORM

This is an application for (please check one)

Membership Renewal

Note: If you are renewing your membership, the only required fields are your name, email address and any changed information.

New Membership

Member / Applicant Information:

Name

Firm/Employer

Address:

E-mail Address (required to receive newsletter):

Telephone No.:

Facsimile No.:

Professional Information:

Are you a member of the California bar?

Yes No

Bar No.

Are you a member of the bar of another state or the District of Columbia?

Yes No

Jurisdiction/Bar No.

Are you registered to practice before the U.S.P.T.O.?

Yes No

Reg. No.

Are you a student?

Yes No

School

Please check not more than TWO committees in which you would like to participate:

Annual Seminar	Law Office Management	Membership
Copyright Practice	Legislation	Patent Practice
Federal Courts	MCLE	Trademark Practice
International Practice	Meetings/Programs	Trade Secret/Unfair Competition

Dues Membership Year (please check one):

Regular Membership (attorneys, agents):

$50.00

Student Membership

$25.00

Associate Membership (other)

$50.00

Membership + Annual Lunch Passport (Regular or Associate)

$360.00

Membership + Annual Lunch Passport (Student)

$180.00