HELLENIC BAR ASSOCIATION - New Member & Membership Renewal Form*

To become a new member of the HBA or to renew your membership, please complete the form below and mail with a check* (see rates for Regular and Law Student membership) payable to the HELLENIC BAR ASSOCIATION to:

Hellenic Bar Association
c/o George Georgountzos, Esq.
38 Montvale Ave., Suite 327
Stoneham, MA 02180

NAME: ________________________________________________________________

FIRM / EMPLOYER: _____________________________________________________

I AM ENCLOSING A CHECK FOR (please indicate):
_____ $75.00 - Regular (Attorney/Professional)
______$50.00 - Law Student Rate [I am a student at _______________Law School]

PREFERRED MAILING ADDRESS (for HBA Correspondence & Invitations):

____________________________________________

____________________________________________

___________________________________________

PREFERRED E-MAIL ADDRESS: _________________________________

TELEPHONE: __________________________

1) Do you want to be listed on the ATTORNEY REFERRAL NETWORK on the HBA Website
(a free service for HBA Members in good standing): YES / NO (circle one)

If YES:

a) Please indicate practice specialty area(s):

_________________________________________________________________

b) Are you fluent in Greek? __Yes/Very ___Moderate ___No

c) Please indicate office contact information that you want listed (if different from above):

Firm address: _________________________________________

________________________________________

Telephone: _____________________________

E-Mail: ______________________________

2) Would you like your professional information listed in an HBA Member Directory? YES / NO

If YES: Please fill out office contact information in above section

*Please Note: Dues payments received after September 1 will be counted toward membership dues in the following calendar year.