The Indianapolis Bar Association is pleased you are interested in participating in the Family Law Modest Means program.

* 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 Family Law Modest Means case types. Please select all that apply.

* 4. I am willing to accept up to x number of Family Law Modest Means cases per month:

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