Ohio > County (Court Of Common Pleas) > Warren > Juvenile Division
Application To Serve As Guardian Ad Litem WCJC-14 - Ohio
| Application To Serve As Guardian Ad Litem Form. This is a Ohio form and can be used in Juvenile Division Warren County (Court Of Common Pleas) . |
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CAROLYN A. DUVELIUS Chief Magistrate ANTHONY BRIGANO Court Administrator MIKE POWELL, JUDGE JOSHUA G. BURNS JENNIFER A. COATNEY Magistrates Warren County Common Pleas Court Probate Juvenile Division 570 Justice Drive Lebanon, Ohio 45036 SHERRY L. KANE JENNA JOHNSON Staff Attorneys APPLICATION TO SERVE AS GUARDIAN AD LITEM NAME: ________________________________________________________________________ ATTORNEY REGISTRATION NUMBER: ________________________________________________________________________ ADDRESS: ________________________________________________________________________ Firm Name _______________________________________________________________________ Street/Suite/PO Box _______________________________________________________________________ City, State, Zip _______________________________________________________________________ Email TELEPHONE NUMBERS: ____________________________ Office ____________________________ Cellular ADMITTED TO PRACTICE: ____________________________ Year of Admission to Ohio Bar ________________________________ Facsimile ________________________________ Home _______________________________ Other States where licensed and year EXPERIENCE AND EXPERTISE: In addition to having obtained the educational requirements set forth below, I have the following experience and expertise that demonstrate my ability to successfully perform the job as Guardian ad litem. 1. Estimated number of cases where I have served as Guardian ad Litem in: a. Warren County Juvenile Court _________ b. Warren County Domestic Relations Court _________ 2. Estimated number of cases where I have represented litigants in Family Law cases in the State of Ohio: _________ Probate Division 513.695.1181 513.695.2945 (Fax) Juvenile Division 513.695.1160 513.695.2948 (fax) Detention Center 513.695.1393 513.695.1394 (Fax) Mary Haven 513.695.1366 513.695.1839 (fax) American LegalNet, Inc. www.FormsWorkFlow.com 3. Any specialized education or training in social work: ________________________________________________________________________ ________________________________________________________________________ 4. Any other relevant experience: ________________________________________________________________________ ________________________________________________________________________ QUALIFICATIONS: (Check all that apply) I have read Rule 48 of the Ohio Rules of Superintendence; I have read Local Rule 5; I attended a six (6) hour pre-service training course on ______________, a copy of which is attached hereto; I understand my obligation to attend an annual three (3) hour continuing education course and notify the Court upon attendance of the same; I have served as a Guardian ad litem for this Court during the five (5) years immediately preceding March 1, 2009 and commit to attending the pre-service training program; Attached is a copy of my resume or curriculum vitae. FOREIGN LANGUAGE ABILITY: _____________________________________________________________________________ Language/Dialect ` I hereby apply to serve as a Guardian ad litem for the Warren County Common Pleas Court, Juvenile Division. I certify that I am familiar with all rules governing Guardians ad litem including Ohio Rule of Superintendence 48 and Local Rule 5 and that I will abide by such rules. I am unaware of any circumstances that would disqualify me from serving as Guardian ad litem. I hereby state that all of the above information is accurate. I hereby agree to provide the Court prompt notice of any complaint that may hereafter be filed against me with the Warren County Juvenile Court, Warren County Bar Association and/or the Supreme Court of Ohio and any disciplinary action taken by either entity. ______________________________ Date ____________________________________ Signature Sworn to and subscribed before me, a Notary Public, this ______ day of ________________________, 20____. ____________________________________ Notary Public WCJC Form 14.0 Eff. 04/04/11 American LegalNet, Inc. www.FormsWorkFlow.com
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