Please print this completed form & mail with appropriate dues & application fees to:
Membership Application
Defense Trial of Indiana
9505 Copley Dr., Indianapolis IN 46260
Phone: (317)580-1233 • Fax: (317) 580-1235 • Email: dtci@dtci.org • Web Site: www.dtci.org
First Name:
Last Name:
Nick Name:
Law Office:
Address Line1:
Address Line2:
City:
State:
Zip:
County:
Email:
Area Code:
Phone:
Fax:
Optional Section Membership/Practice Area(s)/Area(s) of Interest
Business Litigation Insurance Coverage Construction Law Workers' Comp Trial Tactics Employment Law Product Liability Health Law Litigation Nursing Home Pharmacy Malpractice Medical Malpractice Drug and Medical Device In-House Counsel Paralegal
For Voting Members
Do you devote more than 50% of your time to the representation of individuals seeking to recover damages for bodily injury and/or property damage against defendants? yes no
Do you devote a substantial portion of your professional practice in the defense of claims, actions, or suits against individuals, companies, corporations, or agencies? yes no
First year in practice (yyyy)		Number of years in practice
I am am not a member of the Indiana Trial Lawyers Ass'n OR the American Trial Lawyers Ass'n. If you are a member of either ITLA or ATLA, please explain why you believe you qualify for membership in DTCI:
For Non-Voting Members (non-lawyers)
Number of years employed by insurance company or affiliated organization
Number of years involved in company's litigation activities
If not involved in company's litigation activites, list activities compatible with purposes of this association:
Sponsor (current DTCI member)
I AGREE to abide by the by-laws of this Association and am willing to work on behalf of the DTCI and defense bar. I understand that my membership is provisional until final approval is given by the Board of Directors.
Dues Application Fee Total       $75.00 $50.00 $125.00 In practice as a Government Attorney $75.00 $50.00 $125.00 In practice less than three years $185.00 $50.00 $235.00 In practice more than three years $75.00 $50.00 $125.00 Paralegal
We are required to notify you that 18% of your dues is not deductible as an ordinary and necessary business expense for the current tax year because that portion is used to support lobbying. $18 of your dues is for a one-year subscription to the Indiana Lawyer, unless you are a member of the IBA.
Please Sign Here ________________________________
Please print this completed form & mail with appropriate dues & application fees to:
Membership Application Defense Trial Counsel of Indiana 9505 Copley Dr., Indianapolis IN 46260
Hit the submit button to complete the electronic application process.