Please complete every numbered item in the application.  If an item does not apply, insert NA.

Massachusetts Municipal Lawyers Association, Inc.
115 North Street, Suite 3, Hingham, MA 02043
781-749-9922 (office); 617-285-4561 (cell); 781-749-9923 (FAX)
https://www.massmunilaw.org

Executive Director James B. Lampke email: jlampke@massmunilaw.org

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* 1. First Name

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* 2. Last Name 

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* 3. Job Title

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* 4. Email Address (all MMLA notices are sent by email)

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* 5. Mailing Address

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* 6. Office Phone

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* 7. Cell Phone

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* 8. Home Address

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* 9. Year of Massachusetts bar admission

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* 10. Are you a MBA member?

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* 11. List the municipality or local government agency you represent (list all):

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* 12. If you are affiliated with a firm/private organization, state the firm/organization:

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* 13. If you are a non-municipal government counsel, state the agency:

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* 14. Membership Status. Please indicate which of the following applies to your application:

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* 15. Membership Category.  Please identify which of the following four (4) categories for membership applies to you. Under MMLA bylaws, applicants must meet one of these eligibility categories to become a member. If you are uncertain about your eligibility, please contact MMLA Executive Director Jim Lampke for guidance.

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* 16. MMLA Committees.  Please indicate whether you are interested in serving on a committee. You may select more than one.

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* 17. Dues.  Please indicate one of the following:

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* 18. Payment Due.

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