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Life and Health insurance programs from the D.C. Bar 		 
Free Divorce Clinic Registration
  1. Participant’s Information
    Your Name:
    Spouse’s Name:
    Address:
    City:
    State:
    Zip:
    Home Phone:
    Work Phone:
    E-mail:

  2. Select Clinic Dates and Time:
    Thursday, February 16 and 23 6–8 p.m.
    Saturday, March 17 and 24 10 a.m.–12 p.m.
    Thursday, April 12 and 19 6–8 p.m.
    Saturday, May 12 and 19 10 a.m.–12 p.m.
    Thursday, June 14 and 21 6–8 p.m.

  3. How do you prefer that we contact you?
    E–mail:
    Home phone:
    Work phone:
    Regular mail:

  4. Have you and your spouse lived in D.C. for at least the last six months continously before today?
    Yes      No


  5. Are you represented by an attorney in your divorce matter?
    Yes      No

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