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