RANDOLPH COUNTY COURTHOUSE FACILITY
APPLICATION FOR ATTORNEY
NAME OF APPLICANT___________________________________________________
LAST FIRST M.I.
DATE OF BIRTH_________________________
NAME OF LAW-FIRM_____________________________PHONE#_______________
BUSINESS ADDRESS____________________________________________________
CERTIFICATE OF ATTORNEY
I, __________________________ certify that, I have a license to practice law in the State
of North Carolina and I meet the criteria described below.
1) The applicant visits the courthouse for business on a frequent basis.
2) N.C. State Bar Number __________________________.
3) What Day and Time Range will you need access into the courthouse?
________________________________________________________
________________________________________________________
Requirement at Time of Application
1) Completed Application
I understand this I.D. badge cannot be loaned to another individual. I will not allow a person
without a badge to accompany me through the card swipe entrances or carry unauthorized items
into the courthouse. I further understand it is my duty to secure this badge, and agree to contact
Security immediately at 318-6774 if lost or stolen. I understand this is a privilege, which can be
rescinded in the sound discretion of the issuing authority.
Signature of Applicant _______________________________Date______________
COST: 1. $15.00 PER CARD (INITIAL CARD)
2. $25.00 FEE FOR DUPLICATE CARD IF LOST OR STOLEN.
