Only attorneys who have received an email/letter indicating their selection among America’s Top 100 Personal Injury Attorneys® for the current calendar year are eligible to complete this Acceptance Form to join America’s Top 100 Personal Injury Attorneys®. If you have not received a selection email/letter, then completing the Acceptance Form below will not lead to your selection among America’s Top 100 Personal Injury Attorneys®.

Maximum file size: 128 MB.
Maximum file size: 128 MB.

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CERTIFICATION: By digitally signing (typing) my name below, I certify that all information provided herein by me is true and accurate; that I am a current, active, practicing member of my State Bar in good standing; that I have never been disciplined by my State Bar for any reason; that at least 50% of my active legal practice is currently focused on personal injury, catastrophic injury, wrongful death, product liability, and/or medical malpractice matters; and that I consent to my information herein being published in print and online materials for America’s Top 100 Personal Injury Attorneys® and America's Top 100 LLC, including in website materials, printed and online member lists, brochures, press releases, member selection announcements and letters, and other membership advertising and announcement materials.

Upon submitting your completed Acceptance Form here, you will be directed to the payment page.