State Bar of Texas
Sexual Orientation & Gender Identification Issues Section
Membership Form



Last Name: _____________________________________________________

First Name:
_________________ Middle Initial: _________________

Address Line 1:
_____________________________________________________

Address Line 2:
_____________________________________________________

City, State ZIP:
_____________________________________________________

Home Phone:
_________________ Work Phone: _________________

Other Phone:
_________________ FAX: _________________

E-Mail Address:
_____________________________________________________

Website:
_____________________________________________________

Firm Name:
_____________________________________________________

Position:
_________________ Bar Number: _________________

Please make check or money order for $10 payable to State Bar of Texas, Section Membership, and mail with this form to:

State Bar of Texas
Section Membership Department
PO Box 12487
Austin, TX 78711-2487