NAPPA Membership Application Form

To apply for membership,
 please print the following form(s), complete, sign and mail
with payment of $390 to:

NAPPA
930 Florin Road, Suite 200
Sacramento, CA 95831

Name:
Address:
Phone #:
 		Fax #:
Email Address:
Jurisdiction(s) where licensed to practice law:
Employer/Law firm:
Position/Title:
Are you employed by a public entity:    Yes ___ No ___
Are any other NAPPA members employed in your office:    Yes ___ No ___
If you are an employee of a law firm, are you affiliated with any other firm(s), other than the one listed above?
Yes___ No ___

If yes, what are the name(s) of the other law firm(s)?

 
Do you have any office sharing arrangements with any law firms, other than the one listed above? 
Yes___ No___

If yes, please list the name(s) of the firms(s) with which you share space.

 

List public pension fund(s) you represent or advise:

Briefly describe the types of matters on which you represent or advise public funds:
What percentage of your practice is devoted to Public Pension Fund matters: 
Do you represent Public Funds in class actions on a contingency fee basis:    Yes ___ No ___

If yes, does the class include members other than Public Funds:    Yes ___ No ___

If yes, describe any non-class action work you do for Public Pension Funds:

 

In the last five (5) years, have you undertaken an adversarial relationship to a public pension fund or advised a client whose relationship with Public Pension Funds is adversarial:

 Yes ___ No ___

If yes, please describe:

 

I hereby certify that the above is true and correct:

Date: _______________
* Provision of false or misleading information can result in denial or termination of membership.

If you would be interested in speaking at a NAPPA conference or writing for the NAPPA Newsletter, list potential topics on the back of this form and check here: _____

For NAPPA Office purposes only:
Membership category issued/renewed:    

    (Circle one, mark category) 

_____  Governmental Member
_____  Non-Governmental Member

 

Please complete and sign the "Affirmation by Applicant" form
and return with the Application Form and payment.

Please complete and sign the appropriate "Certificate" page if you are a non-governmental counsel.

Visa/MasterCard form available as payment option.