Please enroll me in the Health Law Section. Please send me notification when  the next newsletter is posted and notices of section events at the following address:

NAME:______________________________________________________

FIRM NAME/EMPLOYER:____________________________________________

OFFICIAL ADDRESS OF RECORD:____________________________________________________

____________________________________________________________

E-MAIL ADDRESS: ____________________

TELEPHONE NUMBER: (   ) _____________

FACSIMILE NUMBER: (   )______________

VSB MEMBER NUMBER: ______________

DUES: $20.00 (Payable to the Virginia State Bar)

Print this application and return with dues to:

Health Law Section
Virginia State Bar
707 East Main Street, Suite 1500
Richmond, Virginia 23219-2803