Law Firm Listing Form

         New Jersey Lawyer is please to hear that you will be placing a listing in our Guide to Internet Services 2004-2005 to be published Aug. 2. As a bonus, we will also place your listing in our NJLNews Online Attorney Directory for 3 months. Below is a form we will need to have you complete and fax back to us to reserve space in the guide and directory and to compose your listing.

Please fill out the form below - This is the order in which the information will be printed in the guide. (Note: 'required' indicates a form field that must be completed)

Reserve print and online space for my listing for the one-time fee of $139, paid in advance.

Add my Web site link online for $50
Place under additional practice areas for $70 per listing
Law Firm Information (this information will make up your listing)

Primary Practice Area that best describes your firm:

Other practice areas requested:

Firm Name: (required)

40 word description of your firm's services:

Mailing Address: (required)

Phone: (required)

Web site or E-mail address:

Contact Information (all required, except email and Web link)

Name Authorizing Listing

Street Address:


State:     Zip code:


Email address:

Web link:

Billing Information (all required, unless you pay by check)

Check enclosed (pay to NJ Lawyer)
Charge VISA / Master Card / AMEX

Check off the type of credit card being used for this transaction:
VISA Master Card American Express

Enter Name exactly as it appears on the credit card:

Card Number:

Exp. Date:      Month:       Year:

If you have any questions or problems to report concerning this form, please call 732-650-2864.