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* 1. Name

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* 2. At what email address would you like to be contacted?

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* 3. At what phone number would you like to be contacted?

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* 4. I am currently a(an):

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* 5. Type of work you would like to preform

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* 6. What type of law do you practice?

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* 7. What type of case are you interested in?

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* 8. If you were provided training on a different topic than you listed above would you feel more comfortable taking a different case?

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* 9. How did you hear about LAF?

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* 10. Any other comments?

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