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***If you are not sure if this wallet can receive NFTs, message us before entering your crypto wallet address!***

* Required Fields

Discord user name including the #NNNN (*)

Your email (*)

Name or Pseudonym (*)

Describe your relevant skills to legal, engineering, or both:

Have you paid for membership or are you experiencing financial hardship and would like to work for membership?
I sent the membership contribution!I certify that I have a financial hardship and would like to work for membership.

If you have a hardship and would like to work for membership, are there special skills you have that you can offer?

ETH Wallet Address (*) - Full Address with 0x Please, Not ENS Name (if you have one, if not we'll help you set one up).
You must have a crypto wallet to receive your Membership Token. ***If you are not sure if this wallet can receive NFTs, message us before putting a wallet address here!***

What wallet did you send your contribution from?

When did you send the membership contribution?

Are you a practicing attorney? (*)
YesNo

Would you like to be listed in our public directory? (*)
YesNo

Would you like to receive referrals from LexDAO? (*)
YesNo

What jurisdiction(s) are you licensed to practice?

What are your practice areas?

Do you authorize LexDAO to contact you about relevant news, information, and updates? (*)
YesNo