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Affiliate Attorney Response Card
Use this confidential form to apply to the Rutherford Institute's Affiliate Attorney Program. Once we receive your form, a member of our staff will contact you with more information.
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* Indicates required question
First Name
*
Your answer
Last Name
*
Your answer
Firm / Company Name
*
Your answer
City
*
Your answer
State
*
Your answer
ZIP
*
Your answer
Email
*
Your answer
Phone
*
Your answer
Law School
Your answer
Graduation Date
Your answer
List all states where you are licensed to practice.
Your answer
List all courts in which you are admitted to appear.
Your answer
What is your primary field of law practice?
Your answer
List (in years) your litigation experience.
Your answer
List (in years) your mediation experience.
Your answer
Check the areas in which you are NOT able to assist the Institute.
Free speech and religious liberty in the public arena, including schools.
Protecting churches, parochial and home schools from state intrusion.
Parental rights and family autonomy.
Sanctity of life and/or right to peaceful protest.
Human rights abuses including sexual harassment.
Religious discrimination in employment.
May the Institute provide you with non Institute referrals in your areas of practice?
Yes
No
Clear selection
List any cases or clients whom you have represented on behalf of the Institute in the past.
Your answer
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