Pro Bono Services Intake Form

C O N F I D E N T I A L

(This form is Confidential to Members of NACVA’s Pro Bono Group, Litigation Forensics Board, NACVA HQ, and the Requesting Party, and may not be shared with outside parties.)

Question Title

Requesting Party Contact Information:

Requesting Party Name:

E-mail:

Organization Name:

E-mail:

Address:

City:

State:

ZIP:

Telephone Number:

Question Title

How did you learn about NACVA's Pro Bono Services group?

Question Title

What is your involvement in this matter:

Principal/Litigant—Plaintiff

Principal/Litigant—Defendant

Attorney

Court Appointment

Other (briefly describe)

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Proposed Engagement:

Engagement is with an Attorney

Engagement is with Litigant

Question Title

Provide Principal/Litigant, Attorney, Court Appointment, or Other Contact Information:

Name:

Lead Attorney:

Organization Name:

E-mail:

Address:

City:

State:

ZIP:

Telephone Number:

Question Title

Case Details

Identify all parties in case

Case number

Jurisdiction (i.e. District, Circuit, Federal or indicate appropriate State classification—example Superior Court of Los Angeles County, Department 54)

Court date

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Provide description of the case (i.e. Damages, Oppression, Business divorce, Personal divorce, Other)

Question Title

Describe the nature and extent of expert pro bono services being requested: (large character limitation)

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Is the firm/attorney performing all of its legal services pro bono?

Yes

Partial (explain below)

Please explain:

Note: It is not NACVA’s policy to refer pro bono expert services on cases where the firm/attorney is not also providing services pro bono. Exceptions could apply where partial pro bono services are being provided, thus the explanation required above.

Question Title

Relevant Dates

Fact discovery cut-off

Date expert needs to be identified

Expert report due date(s)

Expert discovery cut-off

Anticipated trial date