Affiliate Member Registration

If you would like to become a affiliate member of the Jacksonville Beaches Bar Association, please complete the registration form below.

Name:(*) Please let us know your name. Firm:(*) Please let us know your firm's name. Address:(*) Please let us know your street address. Phone:(*) Please let us know your office phone. Email: Please let us know your email address. Website Link: Please let us know your website address. Affiliate Member Category Select:(*) Court ReporterMedia & Marketing ServicesBanking ServicesReal Estate Services Please select your Practice Areas! Services Provided: Invalid Input Upload Your Picture or Logo Invalid Input Member Registration Fee: Member Registration Fee: - 80.00 USD 0.00 USD Enter Captcha:(*) Invalid Input