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Small Business Plan Enrollment Form

Thank you for your decision to join Legal Club of America®. Please take a moment to fully read and complete the information below.

Items marked with a red asterisk (*) are required.

First Name: *

Last Name: *

Address One: *

Address Two:

City: *

State: *

Zip Code: *

Home Phone:

Office Phone:

Email Address: *

Payment Options:

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Expiration Date: *	MM: YYYY:

Payment Frequency:

Annually ($299.40)
Three Consecutive Monthly Payments ($99.80)
Monthly ($24.95)

Yes, I want to enroll in the Legal Club of America® Small Business Plan. The membership fee is only $299.40 per year. I will have access to all the services and benefits outlined on the web site, subject to the terms and conditions in the Member Guidebook. Upon enrollment I will have 30 days to cancel my membership. The plan is not party to any confidential relationship which I may establish with any participating attorney. I understand that this plan is not insurance coverage. I understand that costs and filing fees are additional.