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Champions for Justice Pledge Form
Please fill out this form to submit your Champions for Justice 2024-2028 Pledge.
Contact Information
Name of Law Firm or Organization
*
Primary Contact Person
*
First Name
Last Name
Primary Contact Title
Primary Contact Email
*
Verify Email
*
Primary Contact Phone
*
Secondary Contact Person (optional)
First Name
Last Name
Secondary Contact Title
Secondary Contact Email
Verify Email
Secondary Contact Phone
Firm or Organization Mailing Address
*
Address Line 1
Address Line 2
City
City
State
State/Province
ZIP/Postal Code
Pledge Details
Pledge Level
*
Champion ($15,001+ /year)
Platinum ($15,000/year)
Gold ($10,000/year)
Silver Plus ($7,500/year)
Silver ($5,000/year)
Bronze Plus ($2,500/year)
Bronze ($1,000/year)
Other
If "Other" please enter annual pledge amount:
If "Champion" please enter annual pledge amount:
Length of Pledge
*
select one
5 Years
Other
If "Other" please enter length of pledge in years:
Send pledge confirmation to:
*
Check all that apply.
Primary Contact
Secondary Contact
Other
If "Other" please provide contact information:
Send invoice to:
*
Check all that apply.
Primary Contact
Secondary Contact
Other
If "Other" please provide contact information:
Do you have any additional information or specific instructions? (Optional)