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Home
Mission
Services
Team
Testimonials
Representative matters
Engage
Intake Form
Name
*
Please add middle name and preferred name.
First Name
Last Name
Email Address
*
Phone
*
(###)
###
####
Preferred contact method
*
Phone
Email
Current Address
*
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Professional References
Reference 1
*
Unless you have previously provided this information, please provide name, professional relationship, phone number, and email address for three professional references. Provide at least two supervisors and a reference from your current or most recent completed position.
First Name
Last Name
Professional relationship
Phone
*
(###)
###
####
Email
Reference 2
First Name
Last Name
Professional relationship
Phone
*
(###)
###
####
Email
Reference 3
First Name
Last Name
Professional relationship
Phone
(###)
###
####
Email
Employment Experience
How many years do you have as an Attorney?
0
1
2
3
4
5
6
7
8
9
10+
Paralegal?
0
1
2
3
4
5
6
7
8
9
10+
Practice Areas
Indicate experience
in years
next to any practice area in which you are interested in being matched
Litigation
0
1
2
3
4
5
6
7
8
9
10+
Antitrust/Competition
0
1
2
3
4
5
6
7
8
9
10+
Appellate Litigation
0
1
2
3
4
5
6
7
8
9
10+
Class Actions, Mass Torts/Toxic Torts
0
1
2
3
4
5
6
7
8
9
10+
Commercial Litigation
0
1
2
3
4
5
6
7
8
9
10+
Construction Litigation
0
1
2
3
4
5
6
7
8
9
10+
Data Security/Privacy
0
1
2
3
4
5
6
7
8
9
10+
Environmental Litigation
0
1
2
3
4
5
6
7
8
9
10+
ERISA Litigation
0
1
2
3
4
5
6
7
8
9
10+
Food/Drug/Medical Device Compliance and Enforcement Healthcare
0
1
2
3
4
5
6
7
8
9
10+
Insurance Litigation
0
1
2
3
4
5
6
7
8
9
10+
Product Liability Litigation
0
1
2
3
4
5
6
7
8
9
10+
Professional Liability
0
1
2
3
4
5
6
7
8
9
10+
Securities & Shareholder Litigation
0
1
2
3
4
5
6
7
8
9
10+
Trade Secrets Litigation
0
1
2
3
4
5
6
7
8
9
10+
White Collar
0
1
2
3
4
5
6
7
8
9
10+C
Corporate
0
1
2
3
4
5
6
7
8
9
10+
Asset Finance & Securitization Banking & Financial Institutions Capital Markets
0
1
2
3
4
5
6
7
8
9
10+
Corporate Finance
0
1
2
3
4
5
6
7
8
9
10+
Corporate Governance
0
1
2
3
4
5
6
7
8
9
10+
Corporate Reorganization/Bankruptcy Debt Finance
0
1
2
3
4
5
6
7
8
9
10+
Derivatives
0
1
2
3
4
5
6
7
8
9
10+
Emerging Companies and Venture Capital Energy Transactions
0
1
2
3
4
5
6
7
8
9
10+
Environmental Transactions
0
1
2
3
4
5
6
7
8
9
10+
Global Finance
0
1
2
3
4
5
6
7
8
9
10+
Information Technology Transactions Initial Public Offerings
0
1
2
3
4
5
6
7
8
9
10+
Investment Funds
0
1
2
3
4
5
6
7
8
9
10+
Insurance
0
1
2
3
4
5
6
7
8
9
10+
Leveraged Acquisitions
0
1
2
3
4
5
6
7
8
9
10+
Mergers & Acquisitions
0
1
2
3
4
5
6
7
8
9
10+
Private Company
0
1
2
3
4
5
6
7
8
9
10+
Project Finance
0
1
2
3
4
5
6
7
8
9
10+
Real Estate
0
1
2
3
4
5
6
7
8
9
10+
Intellectual Property
0
1
2
3
4
5
6
7
8
9
10+
Biotech/Pharmaceutical/Life Science Copyright, Trademark, Internet and Advertising Data Security and Privacy
0
1
2
3
4
5
6
7
8
9
10+
Patent Infringement Litigation
0
1
2
3
4
5
6
7
8
9
10+
Patent Licensing
0
1
2
3
4
5
6
7
8
9
10+
Tech & IP Transactions
0
1
2
3
4
5
6
7
8
9
10+
Trademark Licensing
0
1
2
3
4
5
6
7
8
9
10+
If a practice area with which you have experience is not listed, please add below.
Have you ever worked for any of the employers listed on your resume under a different name?
Yes
No
If yes, which employer(s) and under what name(s)?
Please provide any information regarding any gaps in your employment history:
Have you ever been involuntarily terminated or offered an opportunity to resign in lieu of termination?
Yes
No
If yes, please explain:
Are you registered with any other legal services companies?
Yes
No
If yes, which one(s):
In which states are you a member of the Bar?
Do you carry professional liability insurance?
Yes
No
If yes, please indicate carrier and coverage level:
Have you ever been subject to a State Bar or comparable disciplinary proceeding?
Yes
No
If yes, please explain:
Has your law license ever been suspended, canceled, or revoked for any reason (including suspensions related to nonpayment of fees or failure to obtain CLE hours)?
Yes
No
If yes, please explain:
Thank you!
