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  Prospective Firm Contact Form  
 
   
Firm Name: Contact:
Telephone Number: Extension:
Alternate Telephone Number: Extension:
Address:  
 
 
City: State / Province:
/
Postal Code: Country:
Email Address:  
 
Number of Offices: Number of Professional Staff:
Number of Partners:  
 
Gross Annual Fees in U.S. Dollars:  
 
What is the biggest challenge currently facing your firm?
   
What are your goals for the next 12 months?
 
What benefits do you seek from membership in an association?
   
Comments:  
   
   
   
 
 
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