State Bar of Wisconsin

Requesting Organization *

To insure that there will be adequate support for the Wills for Heroes clinic, requests must be made by someone with the authority to request a clinic on behalf of a first responder organization.
Contact Person * First Last
Organization's Address *
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
County *
Phone Number * ### - ### - ####
Email *
Notes

You may add additional information about your organization or request in this space. If you would be willing to allow neighboring first responder departments to participate with your group, please indicate that as well.
Do Not Fill This Out