Roster Application

Roster Application Form

General Information

Type Of Account

Personal Information

Please identify other names you may have used with Legal Aid Alberta using the Alias Name text boxes. This will assist Legal Aid staff in determining whether or not you have been on the LAA Roster in the past as a Lawyer or an Assistant to a Lawyer.

Last Name
First Name
Middle Name
Gender
Previously Used Alias, If Applicable

Lawyer Information

Are you exempt of GST?
GST Registration Number
Alberta Law Society Number
Alberta Year Of Call

Student Lawyer Information

Name of Principal
Firm Email Address
Year of Admission (or Expected) to Alberta Bar

Contact Information

Firm Name
Work Number
Work Extension
Mobile Number
Fax Number
Email
Preferred Contact Method
Address 1
Address 2
Address 3
City
Province
Postal Code