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Legal Aid Alberta - Roster Application Form

General Information

Type of Account

Personal Information

Last Name

First Name

Middle Name

Gender

Alias Name

Alias Name

Lawyer Information

Firm’s GST Registration Number

Alberta Law Society Number

Alberta Year of Call

Student Information

Name of Principal

Firm Email Address

Year of Admission (or Expected) to Alberta Bar

Contact Information

Firm Name

Work Number

Work Number Extension

Mobile Number

Email

Preferred Method of Contact

Address 1

City

Address 2

Province

Address 3

Postal Code

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