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Bank of America benefit for D.C. Bar members 		 
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, November 12 and 19 6–8 p.m.
    Saturday, December 12 and 19 10 a.m.–12 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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AIDS Walk October 3, 2009
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