Office of the Wisconsin State Public Defender
Principled Negotiations for Lasting Solutions
Private Bar Registration Form

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

Please check the program you will attend:

Wednesday April 28, 2010         1:00 p.m. to 4:00 p.m.
*Registration Deadline is April 21, 2010* 		GEF I
DCF Room 203 (D203)
201 East Washington Avenue
Madison, WI 53703
Please indicate which breakout session you wish to attend:
Breakout #1 (negotiation of a criminal case)

Breakout #2 (negotiation involving resource allocation for substance abuse treatment program)

Wednesday May 5, 2010         1:00 p.m. to 4:00 p.m.
*Registration Deadline is April 28, 2010* 		Fox Valley Technical College
Room C140: A/B/C
1825 North Bluemound Drive
Appleton, WI 54701
Please indicate which breakout session you wish to attend:
Breakout #1 (negotiation of a criminal case)

Breakout #2 (negotiation involving resource allocation for substance abuse treatment program)

Thursday September 16, 2010         Time TBD
*Registration Deadline is September 8, 2010* 		State Office Building
Lower Level Meeting Rooms, #40
819 North 6th Street
Milwaukee, WI 53203
Please indicate which breakout session you wish to attend:
Breakout #1 (negotiation of a criminal case)

Breakout #2 (negotiation involving resource allocation for substance abuse treatment program)

I am         am not         currently accepting SPD appointments.

Program Fee: Actively accepting SPD appointments
Not actively accepting SPD appointments 		$25.00
$75.00
Total amount enclosed:     $


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

Phil Mergen
Training Assistant
Office of the Wisconsin State Public Defender
315 N. Henry St., 2nd Floor
Madison WI 53703


To secure your registration, please submit payment within three business days of submitting your online registration form.

If you have questions about the program, please contact Phil Mergen at Email or 608.261.0622 or Peter Anderson at Email or 608.267.0581.