Please select only one of the following two options:
c Total No. of Additional Territories ____________ x $50 = $ ________________
OR
c Statewide $300 = $ ________________
08/2020
Additional Territories Form
Please Note: Only use this form if you wish to receive referrals from additional territories. One territory – your home
territory – is already included in the basic registration fee. Your home territory is determined by your OSB address of
record. For example, if your office address is in Salem, the "Marion-Polk Counties" territory is already included in your
basic registration fee.
Instructions: Please check the box for each additional territory you would like or check the “Statewide” box at the
bottom of this form to indicate that you would like to receive referrals from all territories. Each additional territory costs
$50. A statewide registration costs $300. Please check the appropriate box at the bottom of this form, total the cost of
your selection(s), and add that amount to the first page of the registration form where indicated.
c
Territory Territory Composition
c
Downtown, SW and NW Portland Downtown Portland, SW Portland, NW Portland
c
NE and North Portland North Portland, NE Portland
c
SE Portland SE Portland
c
East Multnomah, Hood River and Wasco Counes
Bridal Veil, Corbe, Fairview, Gresham, Troutdale, Wood Village,
Gresham, Hood River County, Wasco County
c
South Washington County Beaverton, Aloha, Tigard, Tualan, King City, Durham
c
North Washington and Yamhill Counes
Banks, Buxton, Cornelius, Forest Grove, Glenwood, Gales Creek,
Gaston, Hillsboro, Manning, North Plains, Sherwood, Timber, Amity,
Carlton, Dayton, Dundee, Lafayee, McMinnville, Newberg, Yamhill,
Sheridan, Willamina
c
North Clackamas County
Boring, Brightwood, Government Camp, Timberline Lodge,
Rhododendron, Sandy, Welches, Zigzag, Happy Valley, Damascus,
Milwaukie, Johnson City, Eagle Creek, Colton, Estacada, Clackamas
c
West and South Clackamas County
Lake Oswego, Lake Grove, Rivergrove, Marylhurst, West Linn,
Wilsonville, Beavercreek, Barlow, Canby, Gladstone, Molalla, Mulino,
Oregon City
c
North Coast & Columbia Counes Clatsop County, Lincoln County, Tillamook County, Columbia County
c
Marion - Polk Counes Marion County, Polk County
c
Linn - Benton Counes Linn County, Benton County
c
Lane County Lane County
c
South Coast and Douglas Counes Coos County, Curry County, Douglas County
c
Southern Oregon Counes Jackson County, Josephine County, Klamath County, Lake County
c
Central Oregon Counes
Crook County, Deschutes County, Grant County, Harney County,
Jeerson County, Wheeler County
c
Eastern Oregon Counes
Baker County, Gilliam County, Malheur County, Morrow County,
Umalla County, Sherman County, Union County, Wallowa County
Name Bar Number
Oregon State Bar Referral & Information Services, PO Box 231935, Tigard, OR 97281-1935
Voice: (503) 431-6408 or (800) 452-8260 ext. 408 • Fax: (503) 431-6444 • Email: ris@osbar.org