Criminal Defense Attorney Directory

As stated in the "List Your Site" page, a listing costs $12.50 per month, with one year payable in advance. Accordingly, if you choose to pay by credit card, your card will be billed $150.00 for each listing. If you instead choose to be invoiced, we will send you an bill to be paid in the amount of $150.00 for each listing. If you desire to be listed in more than one state, just list each state in the first box below, and you will be charged $150.00 for each state listed. **If a state you have chosen for a listing has been subdivided into regions, please also indicate in the first box below, which region you would like your listing to be located. Again each listing is $150.00 per year, so if you want a listing in more than one regional subdivision, each one would cost $150.00.

You are Ordering a Listing for which State(s)?

Total Number of Listings @ $150.00 per listing:

Please provide the following contact information:

Name:
            Name of Law Firm:
                  Street Address:
                  Address (cont.):
                  City:
                  State:
                  Zip:
                  Work Phone:
                  Fax:
                  Email Address:
Website URL (If Appicable):

[Optional] Please describe your experience, qualifications and any other related information to be listed on the Criminal Defense Attorney Directory. (8 Lines Max.)

PAYMENT INFORMATION

Visa        MasterCard              Have us bill you instead?
                                                                (You will be listed when payment is received)

Name on Credit Card

Credit Card Number

Zip Code for Credit Card

Expiration Date
(mm/yy -e.g. 03/07)

Security Code: (Last three digits on back of card)

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confidential information.

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Revised: March 01, 2010