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First Name *
Last Name *
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Email *
Address *
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Have you been a NYSBA Member for 3 consecutive years? *
Yes
No
I've been admitted for less than 3 years
My adjusted Gross Annual Income is: *
$75,000+
$50,000-$74,999
Less than $50,000
I am currently: *
Employed
Unemployed
Underemployed
If unemployed or underemployed, please confirm for how long (in months) *
How many times have you received a dues waiver previously? *
This is my first request
One Time
Two Times
Three Times
Four Times
Five Times or More
Please share any additional comments
Submit Application
DUES WAIVER APPLICATION
*Required Field