Attorney Volunteer Agreement Form

Attorney Full Name

First NameMiddle NameLast Name

Law Firm / Organization Name

Work Email

example@example.com

Work Phone

Please enter a valid phone number.Format: (000) 000-0000.

Preferred Contact Method

Office Address

Street Address

Street Address Line 2

CityState / ProvincePostal / Zip CodeCountry

Country of Primary Practice

Bar Admission State(s)

Bar Status

Other

Bar Number (if applicable)

Years of Practice

Primary Practice Areas

Volunteer interest type

Availability schedule

Preferred commitment duration

Maximum hours per month

Languages spoken

Service delivery preference

Willingness to travel locally

Do you have any current employer or client restrictions to consider for conflict checking?

List any current employer or client restrictions or related limitations

Organizations, industries, or entities to avoid

Matter types you are willing to accept or decline

Geographic limitations

Prior or ongoing representation conflicts to consider

I acknowledge and agree to the terms above

Signature

Date

Emergency Contact Name

First NameLast Name

Relationship to Emergency Contact

Emergency Contact Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

Dietary, Accessibility, or Accommodation Needs (Optional)

Additional Notes or Comments (Optional)