NAVRA Membership Form

NAVRA Membership Registration Form

The information you provide on this form is collected solely for the purpose of facilitating your membership in NAVRA. NCVLI will not use or redistribute information provided for any other purpose without your express consent.

If you are an attorney joining NAVRA please complete the Attorney Member Profile
in addition to the membership registration below and mail, fax, or email the form to:

NCVLI at Lewis & Clark Law School
10015 SW Terwilliger Blvd.
Portland, OR 97219
Fax: 503-768-6255
Email: navra@lclark.edu

Personal Information
First Name:
Last Name:
Title:
Affiliation:

Contact Information
Street Address:
City:
State:
Zip:
Phone:
Fax:
E-mail:

Professional Information

I am (please check appropriate boxes):
	An attorney
	A law student at Law School, graduating in
	An advocate/service provider
	Other

By joining NAVRA you agree to abide by the following code of ethics: To ensure the integrity of information provided and exchanged by NAVRA members, you agree that information provided and exchanged by NAVRA members and the National Crime Victim Law Institute will be used to protect, enforce, and advance victims’ rights and will not be used to undermine or oppose those rights.