Please print and complete application and return with payment to :
MCDAA c/o Membership
720 Light
Street
Baltimore, MD 21230
NAME:
FIRM:
ADDRESS: CITY:
STATE ____________ ZIP CODE:
COUNTY:
PHONE (Office): FAX:
EMAIL: WEBPAGE:
DATE OF BIRTH:
Court of Appeals admission date:
Check one:
Active Criminal Defense Attorney
Law Student - University
Date of Graduation
Judicial officer - title and court
Sustaining Membership Dues............................................$200.00
Regular Membership Dues (More than 5 years in practice)..........$90.00
Regular Membership Dues (1-5 years in practice).....................$75.00
Full Time Public Defender................................................$40.00
Full Time Student..........................................................$25.00
I HEREBY CERTIFY that I am employed as a criminal defense attorney and am not affiliated with any prosecutorial or judicial office.
Date Signature