Asterisks (*) indicate optional items.
First Name:
Last Name:
Address:
City:
State/Province:
Zip Code:
E-mail:
Home Phone:
Work Phone:*
Law School:
Social Security:*
NOTE: Giving us your social security number is necessary for income tax purposes. If you would rather give us this information by calling us, feel free to do so. Please note that until we have a valid social security number for your account, we cannot issue commission checks.
Bar Exam Date:
Bar Exam State:
How did you learn about AdaptiBar?
Are you on the SBA or student government?
Can we ship flyers to your school, to your attention?
Are there bulletin boards where you can hang posters?
Do other bar prep companies set up tables to promote their products?
Does your school-wide e-mail system allow you to send e-mails promoting AdaptiBar?
Are there personal mailboxes at your school that you could put promotional materials in?
Is there a law school newspaper on your campus?
Are you a Bar/Bri representative?
Are you a PMBR representative?
Are you a rep for any other bar prep programs?
In your opinion, what is the best way to advertise AdaptiBar at your law school?
Please read the Student Representative Agreement below and, if acceptable, click the checkbox below to complete the application process. You will also be e-mailed a copy of the agreement for your records.