Application For Volunteer Civil Settlement Attorney Civil Settlement Conference (Dept. 59)

SUPERIOR COURT OF CALIFORNIA COUNTY OF SACRAMENTO APPLICATION FOR VOLUNTEER CIVIL SETTLEMENT ATTORNEY CIVIL SETTLEMENT CONFERENCE (Dept. 59) Type or legibly print your answers. If a question is not applicable, indicate this by writing N/A. Applicants must initial each page of the application as indicated on the bottom of the page. Attach additional pages as necessary. NAME: _________________________________________________________________________ ADDRESS: ______________________________________________________________________ TELEPHONE NUMBER: ___________________________________________________________ FAX: ___________________________ STATE BAR NUMBER: ____________ Email: _____________________________________ ADMISSION DATE: __________________________ EDUCATION: 1. College, university and law school attended, degrees, and dates: _____________________________ _____________________________ _____________________________ ________________________ ________________________ ________________________ _______________ _______________ _______________ 2. Are you a certified specialist in any area of law? Yes ____ No ____. If yes, state the area of law: __________________________________________________________________________ __________________________________________________________________________ __________________________________________________________________________ VOLUNTEER CIVIL SETTLEMENT ATTORNEY -1- APPLICANT'S INITIALS _________ American LegalNet, Inc. www.FormsWorkflow.com LAW PRACTICE: 3. Describe your trial and litigation experience (include names of co-counsel and opposing counsel): __________________________________________________________________________ __________________________________________________________________________ __________________________________________________________________________ __________________________________________________________________________ __________________________________________________________________________ __________________________________________________________________________ __________________________________________________________________________ 4. Describe the general nature of your current practice including the percentage of time you spend on each area of law (e.g. civil litigation, family law, etc.). If your practice has changed substantially over time, please describe the previous practice. __________________________________________________________________________ __________________________________________________________________________ __________________________________________________________________________ __________________________________________________________________________ __________________________________________________________________________ 5. Have you ever had a judgment entered against you in connection with your role as an attorney? Yes ____ No ____. If yes, please describe the particulars: __________________________________________________________________________ __________________________________________________________________________ __________________________________________________________________________ __________________________________________________________________________ 6. Have you ever been disciplined or cited for a breach of ethics or professional conduct by any court, administrative agency, bar association, or other professional group? Yes ____ No ____. If yes, please give the particulars and date(s): __________________________________________________________________________ __________________________________________________________________________ __________________________________________________________________________ __________________________________________________________________________ 7. Have you ever been convicted for violation of any federal law, state law, county or municipal law, or ordinance? Yes ____ No ____. If yes, please give the details. (Do not include traffic or parking violations, unless it also included a jail sentence, including an alternative sentencing program.) __________________________________________________________________________ __________________________________________________________________________ __________________________________________________________________________ __________________________________________________________________________ VOLUNTEER CIVIL SETTLEMENT ATTORNEY -2- APPLICANT'S INITIALS _________ American LegalNet, Inc. www.FormsWorkflow.com JUDICIAL EXPERIENCE: 8. Have your ever held judicial office (including as a commissioner, referee, administrative law judge, or hearing officer) or been a candidate for judicial office? If so, please state the court or agency involved and the dates of service, or dates of candidacy. __________________________________________________________________________ __________________________________________________________________________ __________________________________________________________________________ __________________________________________________________________________ 9. Please describe any prior service as a temporary or pro tem judge (indicate court, case type and approximate hearing dates): __________________________________________________________________________ __________________________________________________________________________ __________________________________________________________________________ __________________________________________________________________________ __________________________________________________________________________ 10. Have you ever acted as a mediator? ____ (years) As an arbitrator? ____ (years) 11. Please describe any prior service as an arbitrator, mediator or settlement conference attorney: __________________________________________________________________________ __________________________________________________________________________ __________________________________________________________________________ __________________________________________________________________________ __________________________________________________________________________ SUPPLEMENTAL INFORMATION: 12. Provide any pertinent information reflecting positively or adversely on you that you believe should be disclosed to the Court and the selection panel in connection with your possible nomination as a Volunteer Civil Settlement Attorney: __________________________________________________________________________ ______________________________