HTML Preview Reservation Form page number 1.
JACQUELYNN B. ROTHSTEIN
DIRECTOR
BOARD OF BAR EXAMINERS
110 EAST MAIN STREET, SUITE 715
PO BOX 2748
MADISON, WI 53701-2748
TELEPHONE: (608) 266-9760
FAX: (608) 266-1196
RESERVATION FORM
UNIVERSITY OF WISCONSIN LAW SCHOOL MAY 2014 GRADUATE
Retain a copy of this form for your records. Complete and return this form to the Board of Bar Examiners
immediately to attend the swearing-in ceremony in Madison on Tuesday, June 3, 2014 at _______. The Board will
accept this form by facsimile transmission at the fax number above. This form must be received at the Board office by
4:30 p.m. on Friday, May 23, 2014 for you to be sworn-in Tuesday, June 3, 2014.
1. I WILL ATTEND I WILL NOT ATTEND
2. When you are introduced to the Court, how should your name be pronounced?
3. Sign your name: Date:
(Name)
4. IF YOU HAVE MARKED “I WILL ATTEND”, PLEASE COMPLETE THE FORM BELOW.
(IF YOU ARE NOT ATTENDING, DO NOT COMPLETE THE FORM BELOW.)
CERTIFICATE MAILING ADDRESS FORM
Sections 1-4 Must Be Typed
1. DATE OF ADMISSION TO PRACTICE LAW IN WISCONSIN
(This is the day you are sworn-in.) ____________________________________________________________
2. ROLL OF ATTORNEYS
A. Type the name under which you will practice law: _____________________________________________________________
Please sign this name when you sign the Attorney Roll Book
(example: Sally Jo Smith).
B. Give the city and state of residence as you will enter it on _____________________________________________________________
the Roll: this information will appear on your certificate. City State
3. CERTIFICATE OF ADMISSION
Type your name as you wish it to appear on your
certificate (example: Sally Jo Smith). ____________________________________________________________
4. MAILING ADDRESS
Supply a permanent address to which your certificate will be _____________________________________________________________
mailed in approximately four months. Firm Name (if applicable)
_____________________________________________________________
Room Number (if applicable)
_____________________________________________________________
Street Address
_____________________________________________________________
5. YOUR SIGNATURE City State Zip Code
(Please sign your name as it will appear on the Roll of Attorneys)
_____________________________________________________________ BBE 4/13
THIS SECTION MUST BE
TYPED