Legal Clinic Intake Form
Thank you for your interest in the Black-Owned Small Business and Nonprofit Clinic hosted by Bradley Arant Boult Cummings LLP in partnership with the Arts & Business Council of Greater Nashville. The clinic on Monday, January 18th at noon is now full, and the next clinic will be on Thursday, February 18. Eligible businesses may receive up to one hour of pro bono legal assistance. Appointments are first come, first served. If you have any questions while completing this form, please reach out to our team at
vlpa@abcnashville.org
.
* Required
First Name
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Your answer
Last Name
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Your answer
Contact Phone Number
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Your answer
Contact Email
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Your answer
Name of Business
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Your answer
Business Mailing Address
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Your answer
I am a(n)
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Individual/Sole proprietorship
Partnership
Limited Liability company (LLC)
Corporation - C sorp
Corporation - S corp
Corporation - B corp
Corporation - Nonprofit
I have not yet filed any business incorporation documents
Other:
Required
Type of Business/Industry
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Choose
Agriculture
Apparel/Fashion
Arts, Culture, & Entertainment
Automotive
Banking/Finance
Biotechnology
Chemicals
Communications/PR/Marketing
Computer/Information Technology
Construction
Consulting
Education
Electronics
Energy
Engineering
Environmental
Food & Beverage
Healthcare
Hospitality
Insurance
Janitorial
Lifestyle
Manufacturing
Media or Telecommunications
Publishing/Printing
Real Estate
Recreation
Retail
Sales
Security
Shipping/Logistics/Warehousing
Staffing
Technology
Transportation
Utilities
For profit (Other)
Nonprofit (Other)
What is the percentage of African American ownership in the business? (If you have not yet started your business, please list the expected ownership).
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Your answer
How many employees does the business have? (If you have not yet started your business, please list the expected number of employees).
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Your answer
What is the business' annual revenue? (Based on most recent tax filings. You may be asked to submit documentation. If you have not yet started your business, please enter a projected revenue amount for your first year).
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Your answer
Please describe your legal issue and/or questions.
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Your answer
In order to qualify for this legal clinic, your business must have 51% or greater African American ownership, less than ten employees, and less than one million dollars in annual revenue. If your company does not meet one or more of the above criteria but you would still like to be considered for the legal clinic, please identify which requirement you do not meet and detail any exceptions that may qualify your need for the services.
Your answer
The upcoming clinic will be held on Thursday, February 18. Please indicate your availability below.
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I am available on Thursday, February 18.
I am NOT available on Thursday, February 18, and would like to be considered for an alternate time on the 18th or future legal clinic.
Submitting your request for legal services does not automatically make does not create any attorney-client relationship between you and VLPA, Bradley Arant Boult Cummings LLP, or their employees, directors, officers, or contributors to this website. By checking "Yes" below, you indicate that you have read the statement above and understand that submitting your application does not create an attorney-client relationship or guarantee assistance through this Legal Clinic program.
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Yes
Required
By checking "Yes" below, you hereby affirm that the above information is correct and complete, to the best of your knowledge and ability.
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Yes
Required
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