Civil Rights Volunteer Attorney Panel Questionnaire And Application

UNITED STATES DISTRICT COURT FOR THE NORTHERN DISTRICT OF TEXAS DALLAS DIVISION CIVIL RIGHTS VOLUNTEER ATTORNEY PANEL QUESTIONNAIRE AND APPLICATION Please return to: Karen Mitchell, Chief Deputy U.S. District Court Office of the Clerk Northern District of Texas 1100 Commerce, Room 14A20 Dallas, TX 75242-1003 NAME: (Last) (First) (Middle) OFFICE ADDRESS: TELEPHONE NUMBERS: Office: Firm Name Home: Fax: Law School: Date Admitted to Texas Bar: Bar Number: Date Admitted to N.D. Texas: Other federal district and appellate courts admitted to (and dates admitted): Professional memberships and affiliations: ______________________________________________________________________________ 2000 (C) American LegalNet, Inc. Indicate your Civil Trial experience by providing approximate totals in the following categories: Jury Trials Bench Trials Court Hearings Depositions Federal Court _______________________ _______________________ _______________________ _______________________ State Court _______________________ _______________________ _______________________ _______________________ Briefly describe your trial experience in both federal and state court (including criminal trial work). Please indicate your experience with civil rights cases by listing the number of cases you have handled in each category below. Nature of Suit Category Voting [441] Employment [442] Housing/Accommodations [443] Welfare [444] Prisoner Civil Rights (General) [550] Prison Conditions [555] Other Civil Rights [440] Number of Cases _____________________ _____________________ _____________________ _____________________ _____________________ _____________________ _____________________ 2000 (C) American LegalNet, Inc. Please note any other legal experience you believe would be helpful in handling civil rights cases: List the names and telephone numbers of two references (attorneys and/or judges) who know of your ability as a trial attorney: Name: Telephone No: How many appointments are you willing to accept per year? ____________ Are you fluent in any foreign language(s)? If so, list: Are you willing to take appointments based on your foreign language proficiency? Have you already handled a case through this panel? If so, when? Are you currently working on it? If you have completed work on the case, how was it resolved (jury trial, settlement, etc.)? I HEREBY CERTIFY THAT THE ABOVE INFORMATION IS TRUE AND CORRECT: Signature Date 2000 (C) American LegalNet, Inc.