Engraved Certificates This application must be typewritten and must be accompanied by a $40 fee in the form of a cashier's check, certified ch money order made payable to "Clerk, D.C. Court of Appeals." Date of Admission Month Day Year Type your name exactly as you wish it to appear on the certificate: If you registered with the D.C. Bar under a different name (e.g., an initial rather than your full middle name) provide an Mail the certificate to: Full Name Address Floor/Suite/Apt. City State Zip Home Phone Office Phone Signature _____________________ Note: The application may be submitted at the time you are administered the oath of admission or at any time thereafte wait approximately three to four months for processing. The certificate is hand-engrossed, and will be sent via first-class 18-inch-long cylindrical tube. In the event you have a change in your mailing address, immediately notify the Committee The Committee is not responsible for a wall certificate not received by the applicant due to a change in address; carefully mailing tube to avoid damaging the certificate. Engraved Certificate Office District of Columbia Court of Appeals Committee on Admissions 500 Indiana Avenue NW Room 4200 Washington, DC 20001 American LegalNet, Inc. www.FormsWorkflow.com