The Pro Bono Project Application
First Name:
Last Name:
Email:*
Firm:
Address:
Address2:
City:
State:
Zip:
Recruited By:
Phone:
Fax:
Bar Number:
Years in Practice:
Foreign Languages:
Areas of Practice:
Start Date:
I am willing to accept cases in the following parishes. (Check all that apply.)
Orleans:
Jefferson:
St. Bernard:
St. Tammany:
St. Charles:
Other Parishes:

Referral Areas: (Check all that apply)

Adoption:
Custody:
Name Change:
Paternity:
Child Support:
Spousal Abuse:
Other Family:
Medicare/Medicaid:
Unemployment:
Veterans Benefits:
SSI:
Social Security:
Wage Claims:
Education:
Workmans Comp:
Other Employment:
Other Welfare:
Tort Defense:
Non Profit Incorp:
Disabled Rights:
Individual Rights:
Immigration:
License:
Prisoner Rights:
Mental Health:
Miscellaneous:
Elderly Legal Problems:
Disabled Legal Problems:
Mediation:
Delinquent:
Neglect/Abuse:
Termination of Parental Rights:
Other Juvenile:
Landlord/Tenant:
Home Ownership/Real Property:
Public Housing:
Federal Subsidized Housing:
Other Housing:
Bankruptcy:
Collection Defense:
Contracts/Warranties:
Consumer Protection:
Public Utilities:
Other Consumer:
Mentor a Case:
Curator:
I am willing to assist in these other areas. (Check all that apply.)
Clinic Volunteer:
Elderly Clinic:
Homeless Clinic:
Succession Clinic:
Volunteer Lawyer of the Day:
Divorce Workshop:
CLE Speaker:
Topic:
Subcommittees:
Fundraising:
Volunteer Recognition:
Community Education:
Newsletter/Publications:
Marketing:
Recruiting:
Law Firm Outreach:
CINC:
Justice For All Ball:
I would like to receive training in the following areas:
To prevent spam - what is 3 plus 4?