Volunteer Lawyer Program Enrollment Form
Yes, I am interested in providing free legal services in the following number of cases per year:
5 or more cases
3-4 cases
1-2 cases
Name (required):
Firm Name:
Address:
Telephone (required):
Fax:
E-Mail:
Year of Admission to the New Jersey Bar:
Foreign Languages Spoken:
Professional Liability Carrier:
Limits of Coverage:
I am willing to accept referrals in the following areas of law:
Bankruptcy
Public Entitlements
Consumer
Health
Foreclosure
Employment-Unemployment
Domestic Violence
Tenancy
Divorce
Tort Defense
Custody-Support
Wills, Powers of Attorney, Health Care Directives
Guardianship
Other - please specify:
SSI Disability
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