UNITED STATES DISTRICT COURT
EASTERN DISTRICT OF NEW YORK PRO BONO PANEL APPLICATION
Name (Last) Name of Firm Business Address E-mail Are you fluent in one or more foreign languages? If yes, please specify:
First
Middle
City
State Telephone (area code and number) *Yes No
Zip Code
DATE OF EDNY ADMISSION
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OTHER ADMISSION(S): yy
mm dd
TYPE OF CASE(S) YOU WOULD PREFER TO REVIEW
Civil rights Social Security
Employment Discrimination No preference
COMMENTS REGARDING QUALIFICATIONS OR AVAILABILITY:
Applicant's Signature
Date
Pro Bono Panel Application - U.S. District Court-EDNY Rev. 2/2003