PRO-BONO PANEL APPLICATION

Name *

First

Last

Email *

Firm, Company, or Organization Name

Office Street Address

City, State, Zip Code

Phone

Fax

WSBA Number

List all states and courts in which you are admitted to practice and in good standing, and the years admitted:

Have you ever been disciplined by the bar of any state or by any court?

If yes, please detail below:

Employment history:

Briefly describe your employment experience since graduating from law school.

Subject areas of practice:

Briefly state the nature of your present practice and areas of practice you are proficient in.

Subject areas of interest:

Briefly state any practice areas of law you are interested in learning more about.

Litigation experience - civil or criminal trials, federal:

Estimate the number of cases.

Litigation experience - civil or criminal trials, state:

Estimate the number of cases.

Litigation experience - civil or criminal appeals, federal:

Estimate the number of cases.

Litigation experience - civil or criminal appeals, state:

Estimate the number of cases.

Litigation experience - other:

Describe your other litigation experience above.

Other legal training or experience

Training or experience the court should consider to assess your qualifications for this panel.

Relevant information

Briefly describe the skills/attributes that best suit you for appointment to the panel, or provide any other information that is relevant to your application.

Name