First Name *

Required!

Last Name *

Required!

Middle Initial

Occupation *

Attorney

Nonattorney

Required!

Firm/Company Name *

Required!

Address 1 *

Required!

Address 2

City *

Required!

State *

Outside USA Alaska Alabama Arkansas Arizona California Colorado Connecticut D.C. Delaware Florida Georgia Hawaii Iowa Idaho Illinois Indiana Kansas Kentucky Louisiana Massachusetts Maryland Maine Michigan Minnesota Missouri Mississippi Montana North Carolina North Dakota Nebraska New Hampshire New Jersey New Mexico Nevada New York Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Virginia Vermont Washington Wisconsin West Virginia Wyoming

Zip Code *

Required!

Telephone (Daytime) *

 Required!

Fax

E-Mail *

 Required!Required!

Gender

Please select gender... Female Male

Enrollment in this program is for career related reason

Please select answer... Yes No

Occupation/Organization

Please select answer... Law Other

If Other, Please specify

Age

Please select age... Under 18 18-34 35-49 50-64 65

Race/Ethnicity

Please select race/ethnicity... African American Asian or Pacific Islander American Indian or Alaskan Native Hispanic/Latino Caucasian

Registration Fee

$100

Payment Contact *

Required!

Payment Phone *

Required!

 

Doing Business As: The charge will appear on your credit card statement as Continuing Legal Education.

Cancellation Policy: No refunds will be given for cancellations received less than 3 days prior, and day-of-program "no-shows." Substitutions are accepted.

Privacy Statement: UW–Madison does not sell, rent, trade or distribute any personally identifiable information obtained from clients to a third party, except in cooperation with government agencies or as required by law. Information collected by the UW–Madison is used for the administrative and operational purposes of our services.

Contact: Please contact CLEW, UW–Madison Law School, clew@law.wisc.edu, if you have any questions about your registration.