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  Copy of Past Bar Application


Special Instructions: Bar Number

Product Code: COPA

PBA Shipping Options:

Please select the appropriate processing option below for your purchase. If you would like a receipt e-mailed to you, be sure to include your e-mail address where indicated.

To purchase via check, please print a request form.


You must include the member's full name, bar number and date of birth in the appropriate fields. Failure to provide this information will delay processing. You may also use this form for any additional notes you would like us to receive. Be sure to include your e-mail address if you would like the application e-mailed to you.

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