Name	(First Name) (Middle Initial) (Last Name)
Title
Affiliation	(firm, company, etc.)
Mailing Address	(Street Address) (City) (State) (Zip)
Phone
Fax
*E-Mail	(*all communications from the AIPLA are sent electronically)

Check one of the following membership categories:

	Active Member – licensed attorney residing in Central Texas and actively engaged in the profession of intellectual property law. ($40/year)
	Associate Member (non-voting) – any other person engaged in or interested in intellectual property law. ($40/year)
	Student Member – student in a Texas law school interested in intellectual property law. ($15/year)

Check this box to opt out of the Public Mailing List that is posted on the Austin IPLA website. (Read our privacy policy for details -- see http://www.austin-ipla.org/memberslist.html)

Please submit current year dues with this application.
Make checks payable to "AIPLA."
Dues are for calendar year terms and are normally to be paid in January.

Amount enclosed: ____________

Send to: Austin IPLA
Michael C. Barrett, Austin IPLA Secretary
c/o Fulbright & Jaworski L.L.P.
600 Congress Avenue, Suite 2400
Austin, TX 78701
(512) 536-3018 voice
(512) 536-4598 fax
mbarrett@fulbright.com