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* 1. Name / Nom :

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* 2. Firm Name & Address / Cabinet et adresse :

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* 3. Telephone Number / Numéro de téléphone :

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* 4. Email / Couriel :

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* 5. I would like to become a member of the following New Brunswick and National Sections and Conferences:
Veuillez m'inscrire aux sections ou conférences suivantes du N.-B. et du Bureau National :

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* 6. National Sections & Conferences (not offered by the CBA-NB Branch):
Sections Nationales (n'existent pas au division du N.-B.) :

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* 7. I am interested in becoming:

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