Louisiana Ethics Administration Program

Create New Certified Trainer/Ethics Liaison Profile

Name


Title	First Name* *	Middle Name	Last Name* *

Mailing Address

Phone Number (555) 555-5555:	* *
Fax (555) 555-5555:

Attorney Information

Bar Roll Number:

Year admitted to practice law in the State of Louisiana (4-digit year):

(If you are not an attorney, please leave the fields for bar number and year admitted to practice law blank.)

Date of Birth (mm/dd/yyyy):

* *

E-mail Address:	* * *
Retype E-mail Address:	*

Password:	* * *	(Five character minimum)
Retype Password:	*

Why are you registering with this system? Please select all that apply.*

I would like to register as an ethics liaison for a State Agency.

I would like to register as an ethics liaison for a Political Subdivision (i.e., city/parish/district).

I would like to register as an ethics agent for my Political Subdivision.

I would like to register as a certified ethics trainer so that I may give ethics training to any public servant in Louisiana.

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