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Council of Advanced Practioners Application

To continue the process, please complete and return your application along with the following documents:
- Biography or CV (less than one page)
- Current photo (JPG or PNG format)
1.Name:
2.Address:
EDUCATION
3.Law School - JD
4.Other Graduate Education
5.Undergraduate Education
BAR ADMISSIONS
6.Provide state and year for all active bar admissions (e.g., NY 2002, NJ 2003)
EMPLOYMENT
- List all employment in elder law, special needs law, and related fields following graduation from law school.
7.Current Employment
8.Prior Employment
9.Please list all certifications related to the practice of law.
- Jurisdiction/organization
- Specialization
- Year of certification
(e.g., FL Elder Law 2013, NAELA Fellow 2017, NELF CELA 2020)
PROGRAMS AND COURSES
List up to five accredited substantive programs or courses that you have presented for other lawyers on elder and special needs law topics (most recent first). Describe each program and your role (presenter, moderator, author, panelist, etc.)
10.Program/Course #1
11.Program/Course #2
12.Program/Course #3
13.Program/Course #4
14.Program/Course #5
15.PUBLICATIONS
List up to three publications authored by you on substantive elder or special needs law topics (most recent first).
16.PROFESSIONAL ASSOCIATIONS AND ACTIVITIES
List associations, activities, positions held, and dates.
17.CIVIC AND CHARITABLE ACTIVITIES
List organization, activities, and dates.
18.Please explain why your practice of elder and special needs law should be defined as preeminent.
Describe in narrative form not to exceed 150 words.
19.ADDITIONAL INFORMATION
List any honors, awards, or additional information that would assist the membership committee in reviewing your application.
20.What are your expectations in joining CAP and how would you like to contribute?
21.REFERENCES
List names and contact information for five attorneys (two of whom must be members of CAP) who will serve as references for you.
CERTIFICATION BY APPLICANT
The undersigned hereby certifies to CAP that the applicant:

1. Be a member of NAELA for at least 10 years and currently a member in good standing

2. Be a Certified Elder Law Attorney (CELA) or Fellow

3. Have made substantial contributions to the elder law and special needs legal field by lecturing, writing, teaching, or being involved in bar activities or the enactment of significant state or federal legislation

4. Be a lawyer to whom the other members in the applicant's jurisdiction would readily refer a matter within the applicant's field of expertise without reservation

5. Commit to participate substantially in CAP, including writing articles on behalf of CAP, or leading or participating in programs, or serving on a CAP committee, and actively participating in NAELA

6. Have malpractice insurance coverage

7. Alternatively, attorneys may also qualify if they are: A full-time elder law professor, A legal services attorney, A sitting judge

I agree to abide by all rules and regulations promulgated by NAELA’s Council of Advanced Practitioners, as amended from time to time.

In making and filing this application for membership, I authorize all persons, firms, officers, corporations, associations, organizations, state or federal agencies, and institutions to furnish to the Council of Advanced Practitioners Steering Committee or any of its authorized representatives all relevant documents, records, or other information that may be requested in the investigation of this application or in any investigation of my continuing satisfaction of the standards for membership.

I further agree that all information received by the Council of Advanced Practitioners Steering Committee may be treated confidentially by the Steering Committee. In addition, I hereby waive my right of confidentiality with regard to any agency (whether state, national, or other) with jurisdiction over legal licensure, disciplinary proceedings, or specialization, and also with regard to any organization or entity approved by the state to certify legal specialists to which I have applied or by which I am certified.

I specifically waive any right to review any Confidential Statements of Reference or other evaluations and references made to the Council of Advanced Practitioners Steering Committee, whether solicited by me or the Steering Committee. In addition, I agree not to seek discovery of such references and evaluations, formally or informally, in any legal proceeding or otherwise.

I agree to defend or pay the costs of defense, at the discretion of the Steering Committee, for any suit or claim initiated concerning my application, or revocation of my membership in the Council of Advanced Practitioners, by the Council of Advanced Practitioners, and to indemnify the Council of Advanced Practitioners for any judgment or settlement ordered or paid as a result of any legal action arising there from.

I agree that in the event my membership in the National Academy of Elder Law Attorneys or in the Council of Advanced Practitioners is suspended or revoked, I shall cease to hold myself out in any way as a member of the Council of Advanced Practitioners, and will remove any indication of such from public display.

By checking this box, I hereby certify that I have reviewed each part of my application carefully, and made each statement and representation therein, and answered each question therein, voluntarily, fully, and frankly without conceal
22.CERTIFICATION BY APPLICANT
The undersigned hereby certifies to CAP that the applicant:

1. Is licensed to practice in the highest court of every state(s) in which the applicant practices law;

2. Has a well-deserved outstanding reputation;

3. Has demonstrated exceptional skill in elder and special needs law;

4. Has not less than 10 years of experience in active private elder and special needs law practice, or is a full-time law professor, or is a full-time judge;

5. Has made substantial contributions to the elder and special needs legal field by lecturing, writing, teaching, or being involved in bar activities or the enactment of significant state or federal legislation;

6. Is a lawyer to whom the other members in applicant's jurisdiction would readily refer a matter within the applicant's field of expertise without reservation;

7. Has been a member of NAELA for at least 10 years;

8. Has malpractice insurance coverage and has attached the declarations sheet;

9. Has not had their law license revoked or suspended in any state, or been publicly sanctioned by a disciplinary authority; and

10. Commits to participate substantially in CAP, including writing articles on behalf of CAP, or leading or participating in programs, or serving on a CAP committee, and actively participating in NAELA.

I agree to abide by all rules and regulations promulgated by NAELA’s Council of Advanced Practitioners, as amended from time to time.

In making and filing this application for membership, I authorize all persons, firms, officers, corporations, associations, organizations, state or federal agencies, and institutions to furnish to the Council of Advanced Practitioners Steering Committee or any of its authorized representatives all relevant documents, records, or other information that may be requested in the investigation of this application or in any investigation of my continuing satisfaction of the standards for membership.

I further agree that all information received by the Council of Advanced Practitioners Steering Committee may be treated confidentially by the Steering Committee. In addition, I hereby waive my right of confidentiality with regard to any agency (state, national, or other) with jurisdiction over legal licensure, disciplinary proceedings, or specialization, and also with regard to any organization or entity approved by the state to certify legal specialists to which I have applied or by which I am certified.

I specifically waive any right to review any Confidential Statements of Reference or other evaluations and references made to the Council of Advanced Practitioners Steering Committee, whether solicited by me or the Steering Committee. In addition, I agree not to seek discovery of such references and evaluations, formally or informally, in any legal proceeding or otherwise.

I agree to defend or pay the costs of defense, at the discretion of the Steering Committee, for any suit or claim initiated concerning my application, or revocation of my membership in the Council of Advanced Practitioners, by the Council of Advanced Practitioners, and to indemnify the Council of Advanced Practitioners for any judgment or settlement ordered or paid as a result of any legal action arising there from.

I agree that in the event my membership in the National Academy of Elder Law Attorneys or in the Council of Advanced Practitioners is suspended or revoked, I shall cease to hold myself out in any way as a member of the Council of Advanced Practitioners, and will remove any indication of such from public display.

By checking this box, I hereby certify that I have reviewed each part of my application carefully, and made each statement and representation therein, and answered each question therein, voluntarily, fully, and frankly without concealment or reservation. Such answers are, within my personal knowledge, true.
23.Applicant Name and Date