Last updated: 8/28/2014
Civil Pro Bono Panel Volunteer Form
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Description
United States District Court Western District of Tennessee 167 N. Main, Room 242 Memphis, TN 38103 (901) 495-1367 (fax) venita_griffin@tnwd.uscourts.gov (email) Civil Pro Bono Panel Volunteer Form Please Print or Type: Attorneys Name: Board of Prof. Resp# Address: City/State: Zip Code: Phone: Email Address: Date licensed to practice law: _____________/_____________/_____________ Date admitted to practice law before this Court: ____________/_____________/__________ Please check the kind of cases you agree to accept: Employment Discrimination Prisoner Civil Rights Other Civil Rights Social Security Other (Miscellaneous) ____I am willing to serve on the Pro Bono Panel Screening Committee whenever additional members are needed. ____I have received and reviewed Local Rule 83.2 and the Plan for Reimbursement of Expenses. I agree to abide by the conditions of appointment stated therein. Signed: ___________________________________________ Date: _________________ American LegalNet, Inc. www.FormsWorkFlow.com
