WISCONSIN STATE PUBLIC DEFENDER
PRIVATE BAR SPECIALTY CERTIFICATION TRAINING
JUVENILE CASES—VIDEO REPLAY
Thursday May 29, 2008
9:00 a.m. to 4:00 p.m. (check-in begins at 8:45 a.m.)
State Public Defender’s Administration Office—Banoul Conference Room
315 N. Henry Street, 2nd Floor
Madison, Wisconsin

PRIVATE BAR REGISTRATION FORM


Last Name:           First Name:
Organization:
Address:
City:     State:     Zip:
Telephone:                Fax:
Email:           State Bar Number:

Please note that if you are currently provisionally certified for juvenile cases, and you wish to become fully certified, then you must attend this training.

JUVENILE CERTIFICATION TRAINING REGISTRATION FEES:

Attorneys who are actively taking SPD cases: $20
Attorneys who are NOT actively taking SPD cases: $60
TOTAL PAYMENT AMOUNT:


Please submit check or money order (credit cards cannot be accepted) made payable to “State Public Defender” to:

Phil Mergen
Training Assistant
Office of the State Public Defender
315 N. Henry St., 2nd Floor
Madison, WI 53703
Email
Telephone: 608.261.0622
Fax: 608.267.0584