ALPS CLE Registration

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New User Registration

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Prefix

First name

Last name

Company/Firm

Date Of Birth

Office Phone

Please format as: +1 (000) 000-0000

Country

Address

Address Line 2

City

State

Zip Code

Primary Bar Number

If you have no Bar number, please enter NA here.

Primary Bar Number

Primary State Licensed In

If you have no Bar number, please enter NA here.

Primary State Licensed In

Secondary Bar Number

Secondary State Licensed In

Are you in Private Practice?

Yes No

Is your firm insured with ALPS?

Yes No

If no, who is your current insurance carrier?

What month does your current policy expire? (If w/ ALPS, select that option)

How many attorneys are in your firm?