Client Application
The Innovate Capital Business Law Clinic (the "Clinic") is an educational program of Campbell Law School. In the Clinic, student-attorneys represent companies that would not otherwise be able to afford legal services on a variety of matters and meet other eligibility requirements. Applicants are not guaranteed services even if they are eligible. Whether the Clinic can accept any particular potential client depends on a number of factors, including not only client eligibility but also the clinic’s current workload, conflicts and other professional responsibility considerations, and our assessment of the fit between the legal services we provide and the needs of the potential client. All student attorney representation is provided under the supervision of the Clinic Co-Directors or another fully licensed attorney. Please review our website for more information.

NOTICE JANUARY 12, 2020: We have made our initial selections for clients this semester. If you chose to complete this application, it will be waitlisted, and we will contact you later if we are able to engage with additional clients.

Please respond to all questions below (unless indicated as optional). Replies of "N/A" or "Not known" are acceptable.
Email address *
What is your name (First and Last)? *
Your answer
What are your preferred pronouns? (OPTIONAL)
Please specify your ethnicity. (OPTIONAL)
Are you seeking legal counsel on behalf of: *
What is the (actual or proposed) name of your company? *
Your answer
Where is your business located? *
Your answer
Have you formed a company? *
If you have formed a company, in what state is it organized? *
If you have formed a company, it is a: *
If you have formed a company, have you made an S-Corp election? *
What is your title or relationship to the venture? *
The Clinic is a pro-bono clinic, and as such, we seek to provide legal and business assistance to those entrepreneurs and companies that cannot otherwise afford private representation. Please respond below and to the following questions designed to help us assess your eligibility. *
Please briefly describe your financial circumstances in the space provided below: *
Your answer
Does your company have any assets (cash or otherwise)? *
Does your business have any revenue? *
Does your business have any marketable products at this time? *
Have you or has your business raised any capital? (Mark all that apply) *
Briefly describe your business or idea *
Your answer
Do you have a written business plan or slide deck? *
Please list the names of all the founders/owners of the company, or all the individuals who have (or will claim) ownership once a company is formed. *
Your answer
Please list the names of any members of the Board of Directors or Managers of the company: *
Your answer
Please list the names and titles of any officers of the company: *
Your answer
Please list the names and titles of any persons or individuals that may be in an “adverse” position with respect to the company or the subject matter of the representation: *
Your answer
During each semester the clinic will spend two weeks focused on the following “Featured Clinic Topics”. Please see the Clinic's website for more information on the items covered by Featured Clinic Topics. If you would like assistance in any of these areas, please check the box next to the topic. Our goal is to address these issues during the time frames outlined on the website (beginning in early February or late August, depending on the semester in which you are applying for the Clinic): *
What are the legal and business issues you currently have or expect to have? Please mark all that apply: *
Do your legal needs have any upcoming firm deadlines? Note that most work is covered based upon the schedule of Featured Clinic Topic described on our website. *
Your answer
What is your Address? *
Your answer
What is your Phone Number *
Your answer
Are you affiliated with Campbell University? Please mark all that apply *
Are you affiliated with HQ Raleigh? *
Are you affiliated with NC State Entrepreneurship Clinic of the Management, Innovation & Entrepreneurship Department Poole College of Management? *
If you are you a student, faculty member or otherwise affiliated with another university, please identify the nature of your affiliation *
Has any team member used the Clinic's services before, or been a member of a venture that is or was a clinic client? *
Has anyone from your venture been employed by or affiliated with any employer or academic research program that relates to the venture or technology in question? *
If you are part of any accelerator or similar programs, please identify *
How did you hear about the Clinic? *
The Clinic is a training ground for future lawyers. The Clinic includes in it’s acceptance criteria the willingness of Clients to contribute the quality of the student lawyer’s education experience. Please indicate whether you are willing to do any of the following beyond what is required for students to prepare documents for you. Mark all that apply *
Please check below to confirm that: (a) All of the information submitted is accurate to the best of your knowledge, (b) This interaction does not establish an attorney-client relationship. You may seek another legal resource, you may not qualify for representation, or the Clinic may decline to undertake representation for any reason. Any attorney-client relationship, if any, will be formed only via a countersigned engagement letter after further discussion. (c) Because the Clinic is staffed by law students, the sufficiency of Clinic resources to meet immediate deadlines or time-sensitive matters is constrained by the availability of students, which is seasonal and dependent on the academic calendar, and therefore the Clinic may be unable, or may decline, to take on your matter if it is time-sensitive. If appropriate, the Clinic may refer you to outside counsel. *
Please confirm whether you would like to be placed on our waitlist if we are not able to undertake representation at this time. *
IMPORTANT INFORMATION ABOUT OUR CO-DIRECTORS: The Co-Directors of the Business Law Clinic are also the Co-Founders and owners of Innovate Capital Law, a for-profit law firm. Since the Co-Directors are in private practice outside of the Clinic, there may be a financial incentive for the Co-Directors to steer applicants and clients of the Clinic to their firm for private representation. The Co-Directors do not believe that this relationship will impair the Clinic’s representation of you or their ability to supervise Student Attorneys. Further, should private representation be appropriate or necessary for you, you have the right to counsel of your choice and the Co-Directors and Clinic will endeavor to provide you with enough information to make an informed decision. You have many options in the choice of legal counsel should you need to obtain one outside of the Clinic. You are not required to engage Innovate Capital Law nor will it be the appropriate or acceptable choice in all circumstances. We will endeavor to provide you with advice about the representation alternatives should such circumstances arise. *
A copy of your responses will be emailed to the address you provided.
Never submit passwords through Google Forms.
This form was created inside of Campbell University. Report Abuse