Username* E-mail* First Name* Last Name* Attorney # Number of Years in Practice Firm Name Firm Address* Firm Address 2 City* State* Choose Your State...AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming Zip County* Select County...AdamsAllenBartholomewBentonBlackfordBooneBrownCarrollCassClarkClayClintonCrawfordDaviessDearbornDearbornDecaturDeKalbDelawareDuboisElkhartFayetteFloydFountainFranklinFultonGibsonGrantGreeneHamiltonHancockHarrisonHarrisonHendricksHenryHowardHuntingtonJacksonJacksonJasperJayJeffersonJenningsJohnsonKnoxKnoxKosciuskoLaGrangeLakeLaPorteLawrenceMadisonMarionMarshallMartinMiamiMonroeMonroeMontgomeryMorganNewtonNobleOhioOrangeOwenParkePerryPerryPikePikePorterPoseyPulaskiPutnamPutnamRandolphRipleyRushScottShelbySpencerSt. JosephStarkeSteubenSullivanSullivanSwitzerlandTippecanoeTiptonUnionVanderburghVermillionVigoVigoWabashWarrenWarrickWashingtonWayneWellsWhiteWhitleyOut of State County of Residence* Select County of Residence...AdamsAllenBartholomewBentonBlackfordBooneBrownCarrollCassClarkClayClintonCrawfordDaviessDearbornDearbornDecaturDeKalbDelawareDuboisElkhartFayetteFloydFountainFranklinFultonGibsonGrantGreeneHamiltonHancockHarrisonHarrisonHendricksHenryHowardHuntingtonJacksonJacksonJasperJayJeffersonJenningsJohnsonKnoxKnoxKosciuskoLaGrangeLakeLaPorteLawrenceMadisonMarionMarshallMartinMiamiMonroeMonroeMontgomeryMorganNewtonNobleOhioOrangeOwenParkePerryPerryPikePikePorterPoseyPulaskiPutnamPutnamRandolphRipleyRushScottShelbySpencerSt. JosephStarkeSteubenSullivanSullivanSwitzerlandTippecanoeTiptonUnionVanderburghVermillionVigoVigoWabashWarrenWarrickWashingtonWayneWellsWhiteWhitleyOut of State Firm Phone Required phone number format: (###) ###-#### Firm Fax Required phone number format: (###) ###-#### Practice Areas/CommitteesBusiness LitigationConstruction LawDiversity and InclusionEmployment LawHealth Law LitigationInsurance CoverageProduct LiabilityTrial TacticsWomen in the LawWorkers CompFor Voting Members Do you devote more than 50% of your time to the representation of individuals seeking to recover damages for bodily injury and/or property damage against defendants?YesNo Do you devote a substantial portion of your professional practice in the defense of claims, actions, or suits against individuals, companies, corporations, or agencies?YesNo I am a member of the Indiana Trial Lawyers Ass'n OR the American Trial Lawyers Ass'n. If you are a member of either ITLA or ATLA, please explain why you believe you qualify for membership in DTCI:YesNo Please Explain: Referring DTCI Member Name Are you a current DRI Member?YesNo If you have never been a member of DRI, would you like to join DRI and receive free registration for one seminar in your first 18 months?YesNo Download and submit new DRI membership requests: DRI Membership Request Honeypot I AGREE to abide by the by-laws of this Association and am willing to work on behalf of the DTCI and defense bar. I understand that my membership is provisional until final approval is given by the Board of Directors.* We are required to notify you that 18% of your dues is not deductible as an ordinary and necessary business expense for the current tax year because that portion is used to support lobbying. Upon submission of this application, you will be required to submit payment. You must complete this payment to have your application considered. **The membership price includes a $50 Application Fee Payment Instructions: When you click the submission button you will be automatically redirected to the payment options page. Your application will not be considered until valid payment has been recieved.
