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First Name*

Last Name*

Law Firm Name

Firm Size

Solo Practitioner

Small Firm (5 employees or less)

Medium to Large Firm (more than 5 employees)

Website

Email*

Address*

Street Address Address Line 2 City State ZIP Code

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Work Phone Ext.*

Cell Phone*

Number of Years of Experience in a (Qualified) Area of Real Estate Law*

Area(s) of Real Estate Specialization and Expertise*

List Other Area of Real Estate Specialization and Expertise

Secondary Area of Expertise in Law

Licensed in*

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Please Identify Your Geographical Areas by Counties of Practice

What Other Counties Do You Practice In?*

What States Do You Practice In?*

Do You Have Professional Liability Coverage?*

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