The Indianapolis Bar Association is pleased you are interested in participating in the Criminal Modest Means Project.

* 1. Name (First Name, Middle Initial, Last Name, Suffix)

* 2. Indiana Attorney Number (Please include the dash and numbers after the dash. Example: #####-##)

* 3. I am willing to accept the following Criminal Modest Means case types. Please select all that apply.

* 4. I am willing to accept up to x number of criminal modest means cases per month:

* 5. I have read and agree to abide by the Criminal Modest Means Project Rules & Regulations.