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SPONSOR 5.24.23 NUTS & BOLTS OF DIVORCE SEMINAR

Name*
First Last
Florida Bar Number
Address
Street Address Address Line 2 City State ZIP Code
Firm
Email*
Phone*
Payment Options*
- I will attend and accept at least one pro bono Family Law case from PSB.
- I will attend. Please charge my credit card $150.00
- I will attend and mail in a check for $150.00
- I am a speaker, public interest or staff. No charge.
- I would like to be a sponsor. Please complete form below.
I would like to make an additional donation to Dade Legal Aid.
I WOULD LIKE TO BE A SPONSOR IN THE AMOUNT OF...
- $250.00
- $500.00
- $1000.00
Name
First Last
Credit Card Number (Note: We do not accept American Express)
Exp. Date

MM/YYYY
CVC Code
Total
$0.00
To pay by check, please print and fill out form and then mail your check for $150.00, made payable to Dade Legal Aid to:

Dade Legal Aid/Put Something Back 28 W. Flagler St., Suite 608, Miami, FL 33130;
Ph: (305) 579-5733 Ext. 2252;
Email: psb@dadelegalaid.org

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