Statement of Goals of Philadelphia Law Firms and Legal Departments for Increasing Minority Representation and Retention

Subscriber Form

We have reviewed the Statement of Goals of Philadelphia
Law Firms and Legal Departments for Increasing Minority Representation and Retention.

_____ We hereby subscribe to the Statement of Goals.

_____ You may inform others that we support your efforts.

_____ We would like to personally discuss the Statement with you or
          another representative of the Philadelphia Bar Association.

_____ Let us know if there are other ways that we may help you in this
          effort.

_____Other:____________________________________________________

______________________________________________________________

______________________________________________________________

______________________________________________________________

NAME/TITLE:___________________________________________________

FIRM/COMPANY:_______________________________________________

ADDRESS: ____________________________________________________

TELEPHONE:______________________ FAX:________________________

DATE: ____________________________________

Please return this form to:

Scott F. Cooper, Esquire, Chancellor
Philadelphia Bar Association
1101 Market Street, 11th Floor
Philadelphia, PA 19107-2911