Application for L4EJ Fall 2018 Class
Please complete the following application. Please send your resume and law school transcript to Keneecha Mays at kmays@L4EJ.org, and please be sure to include your name in the file names.
Please select your preferred program: *
Name: *
Your answer
Home Address: *
Your answer
Home Phone:
Your answer
Cell Phone:
Your answer
Email: *
Your answer
Law School: *
Your answer
Graduation Year: *
MM
/
DD
/
YYYY
Month and Year of admission to Georgia bar OR month and year bar exam taken: *
MM
/
DD
/
YYYY
Other bar admissions and dates:
Your answer
If currently practicing law, do you carry malpractice insurance?: *
Have you ever had a complaint or grievance filed against you with the State Bar of Georgia? *
Describe your vision for your firm, including your practice area/s and your target market: *
Your answer
Why do you want to practice in the area of law you chose? *
Your answer
How will your firm or the services you offer be different than what is currently available? *
Your answer
What role will reduced-fee or pro bono services play in your firm? Be specific: *
Your answer
How will your participation in L4EJ further your goals for your practice and your firm? *
Your answer
Describe a circumstance when you demonstrated entrepreneurial initiative: *
Your answer
Describe an experience or activity that demonstrates your commitment to community service or pro bono work: *
Your answer
Personal/Professional Reference: *
Your answer
How this reference knows you:
Your answer
Email:
Your answer
Telephone/Cell:
Your answer
Personal/Professional Reference: *
Your answer
How this reference knows you:
Your answer
Email:
Your answer
Telephone/Cell:
Your answer
Personal/Professional Reference: *
Your answer
How this reference knows you:
Your answer
Email:
Your answer
Telephone/Cell:
Your answer
By providing this information, you understand you are authorizing L4EJ to contact these individuals to discuss your application for participation in L4EJ. *
How did your hear about L4EJ? (If from a current or former participant, please give their name(s)).
Your answer
I understand my eligibility to join and remain in L4EJ requires I continue to be a member of the State Bar of Georgia in good standing: *
If I am selected to participate in L4EJ, I agree to carry at all times while I am part of the program malpractice insurance in amounts as described in the Participation Agreement: *
If selected, I agree to perform the required amount of pro bono hours each month during my participation in L4EJ in programs or with clients approved by the L4EJ Executive Director: *
I understand that L4EJ has a conflicts policy that prevents any attorney in the program from taking on a matter or client that would make them adverse to the client of any other attorney in the program, without an exception granted by the L4EJ Executive Director. If selected, I agree to perform conflict checks consistent with this policy: *
By initialing this application, I acknowledge and certify that all statements in this application and accompanying attachments are true to the best of my knowledge and reflect realistic projections based on information reasonably available to me. I understand that any material misstatements herein may be the subject of termination of my participation in L4EJ should I be selected. Please initial below: *
Your answer
All requested materials will be reviewed as received. There are a limited number of spots available for participation in L4EJ. The election process is competitive and selections are made on the basis of qualifications of the applications. L4EJ does not discriminate on the basis of race, color, national origin, religion, sex, sexual orientation, age, disability or veteran status.
Your answer
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service