AIDS Legal Referral Panel (ALRP) » ALRP Panel Online Application

First Name *

Last Name *

Law Office or Firm

Mailing Address *

City *

State *

Zip / Post Code *

Work Phone *

Work Fax

Work Email *

Home Phone

State Bar Number *

Law School *

Graduation Year *

How did you learn about our panel?

Other Source

What are your gender and pronoun preferences?

ALRP is committed to respecting the gender identities of our volunteers.

What is your ethnicity or race?

In order to broaden its community base and effectiveness, ALRP is committed to recruiting volunteers of many ethnic backgrounds.

What languages other than English are spoken fluently by you and/or at your office?

(including sign languages)

Does your firm have a policy to accept only indigent clients for pro bono work?

Yes
No

Are you licensed to practice law in the State of California? *

Yes
No

Have you ever been or are you currently being sued for malpractice? *

Yes
No

Have you ever been suspended from practice or disbarred in any state? *

Yes
No

Have you ever had or are there currently pending any state bar disciplinary proceedings against you? *

Yes
No

Have you ever been disciplined, suspended or removed from any other Lawyer Referral Panel? *

Yes
No

Describe the circumstances of your yes answer(s) in detail

Counties you are willing to serve *

San Francisco
Marin
Alameda
San Mateo
Contra Costa
Solano
Other (indicate below)

Other Counties

Areas in which you will accept ALRP referrals *

Bankruptcy
Confidentiality
Conservatorship
Contracts
Corporations
Credit
Criminal
Discrimination
Employee Benefits (e.g. ERISA)
Employment
Estate Planning
Ethics
Fair Housing
Family
Government Benefits (e.g. SSI/SSDI)
Guardianship
Immigration
Insurance (e.g. Bad Faith Claims)
Landlord/Tenant
Landlord Only
Tenant Only
Mediation
Medical Malpractice
Notary
Personal Injury
Police Misconduct
Probate
Public Accomodations
Real Estate
Restraining Orders
Small Business
Special Needs Trusts
Tax
Tort
Traffic Violations
Trust
Wills & Powers of Attorney
Workers' Compensation
Other (please describe below)

Describe any expertise or limitations you have in the selected legal areas or any additional areas of law you practice

I have read and am familiar with the AIDS Legal Referral Panel's Rules and Fee Protocol and I agree to abide by them. *

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Are you human? What is three times three? (Use digits) *

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ALRP Panel Online Application

Contact Information

Personal Information

License to Practice Law

Serving ALRP Clients

Rules & Fee Protocol

Events

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