Maria E. Garcia
Law Clerk
Member Application
PERSONAL DATA

Please note that our member directory cannot accommodate accented letters. We apologize for the inconvenience.

Position/Title*
Fax
Home Work
Work Home Both
EDUCATION

BAR ADMISSIONS
1
2
3
LISTING BY AREA OF PRACTICE

Yes No
PRACTICE SETTING

Which Setting best describes your office?

Attorney, Private Practice, Solo Practitioner
Attorney, Private Practice, Between 2-5 Attorneys
Attorney, Private Practice, Between 6-15 Attorneys
Attorney, Private Practice, Between 16-25 Attorneys
Attorney, Private Practice, Between 26-50 Attorneys
Attorney, Private Practice, Over 50 Attorneys
Attorney, Corporate Practice
Attorney, Federal Government
Attorney, State Government
Attorney, Municipal Government
Attorney, Public Interest Organization
Paralegal/Legal Assistant
Law Firm Administrator
Law Graduate Not Admitted to Practice
Attorney, Retired
Judge, Federal
Judge, State
Judge, Probate or Other
Professor
Law Student
Special Member (college student, honorary member)

CHBA COMMITTEE

Would you be interested in joining a CHBA Committee?

No, thank you
Yes

Would you be interested in serving as a mentor to a law student?

No
Yes
ETHNIC ORIGIN (optional)
Central American   Country
Cuban
Dominican
Mexican
Portuguese
Puerto Rican
South American   Country
Spaniard   Region
Other
LANGUAGE ABILITY

List languages other than English, describing your level of ability (optional)

Fluent Proficient Writing Proficient Speaking
Fluent Proficient Writing Proficient Speaking
UPLOAD PICTURE

I certify that I have the right to distribute this picture.
MEMBERSHIP DUES SCHEDULE

IMPORTANT TAX INFORMATION
Dues to CHBA are not deductible as a charitable contribution but may be deductible as an ordinary and necessary business expense. A portion of dues, however, is not deductible as an ordinary and necessary business expense to the extent that CHBA engages in lobbying.


Please check one:
Attorneys in practice ($50)
Paralegals/Legal Assistants/Law Firm Administrators($25)
Law Graduates Not Admitted to Practice/Retired ($10)
Law Students, Judges, Law Professors, and Special Members (No Fee)
PAYMENT TYPE
Credit Card (Credit card fee will be added on next screen (Typically $1 - $2))
Check
No Fee Required

I hereby apply for membership in the Connecticut Hispanic Bar Association and certify that I have read and agree to the conditions of membership set forth in the Association's Bylaws and further that, if I am applying to be an attorney member of the Connecticut Hispanic Bar Association, I am a member in good standing, as of this date, of the bar in the jurisdiction(s) indicated above.


I hereby authorize the Connecticut Hispanic Bar Association to publish my name, likeness, and contact information in its member directory and/or Find a Member page (if applicable), whether such directory or Find a Member page is printed in paper, electronic, or other form. In addition, if I selected to be published on the Find a Member page, I understand that I, and not the CHBA, am wholly responsible for compliance with the State of Connecticut Rules of Professional Conduct and any other legal requirements controlling attorney advertising.


A check mark in the box to the left constitutes your confirmation of the above statements.