HAWL Attorney Referral List Application
Please note that all applications will be reviewed for inclusion on the HAWL Attorney Referral List.
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Attorney Name (Last): *
Attorney Name (First): *
Florida Bar Number: *
Law Firm/Business Name: *
Physical Office Address: *
Are you board certified by The Florida Bar in any area of law?  *
Specify board certification area:
List any other states in which you currently are admitted to practice:
Florida counties from which you will handle cases. (Check all that apply.) *
Required
Please list any foreign languages spoken by you:
Application Certification

By checking the box below, I certify that I am currently competent to practice in the areas of law which I have indicated. I further certify that I am licensed in Florida, a member in good standing of The Florida Bar, and maintain a bona fide office physically located in Florida. 

I CERTIFY THAT IT IS MY RESPONSIBILITY TO ADVISE HAWL OF ANY CHANGES TO MY LICENSE STATUS OR PRESENCE OF A PHYSICAL OFFICE IN FLORIDA.

Under penalty of perjury, I hereby swear and affirm that the information submitted is correct.

I understand that this application is made only on my behalf and not on behalf of my firm/organization or any of my associates. I understand that the information contained herein may be furnished to people who seek assistance from the HAWL Attorney Referral List, and that the HAWL ARL, in so doing, will rely on the representations made herein.

I agree to abide by all of the rules of the HAWL ARL and indemnify and hold harmless The Hillsborough Association for Women Lawyers and any of its officers, members or employees from any and all claims, demands, actions, liability or loss which may arise from, or be incurred as a result of the operation of the HAWL ARL or referrals of clients through the HAWL ARL, or by my failure to comply with any provision of the rules of the HAWL ARL or use of information contained in the application.

If at any time the HAWL Attorney Referral List Committee receives notice or information giving it reasonable grounds to believe that a member does not meet the required standards of responsibility, capability, character, and integrity, it may suspend a member from participation on the HAWL ARL for such reasonable time as may be necessary.
 *
Required
How would you like to receive referral inquiries? (Check all that apply.) *
Required
Telephone number (please provide the best number for referral inquiries):
E-mail Address (please provide the best email for referral inquiries): *
Secondary E-mail Address (if any):
Practice Area - FOR REFERRAL ONLY (Check all that apply.) *
Required

Are there any types of cases within your practice area(s) that you will not accept (e.g., Domestic Violence cases in Marital and Family Law Litigation)?

Are there any types of cases within your practice area(s) that you would like to see grow in your practice (e.g., Military Divorces in Family Law Litigation)?

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