Completing this form does not guarantee acceptance into the VLP program. 

This form is to be used by participants who have not contacted CLEAR. VLP staff will contact you if you qualify for services.

Due to the high volume of applications we receive, the VLP is scheduling clients approximately six weeks from the date of completing this application. 

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* 1. Contact Information

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* 2. Do you have any court dates coming up?

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* 3. How many people live in your household?

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* 4. What is your total monthly income? (Enter dollar amount)

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* 5. Who is the other side? Notes: Even if you are in agreement, the other parent in a Parenting Plan/ Parenting Plan modification or other person in a divorce should be listed here. In an Eviction Matter, this will likely be the name of your landlord or the property management company. (put N/A if unknown)

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* 6. Is there a Protection Order or No-Contact Order?

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* 7. How would you describe your gender?

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* 8. How would you describe yourself?

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* 9. If the previous questions do not allow you to accurately identify your race or ethnicity, please describe here how you would identify yourself.

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* 10. Do you have a disability?

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* 11. Are you a veteran?

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* 12. Are you a United States Citizen?

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* 13. What is your current living situation?

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* 14. If you rent, are you up-to-date on rent?

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* 15. If you are not up-to-date on rent, would you like information about resources to assist you? 

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* 16. What is your occupation?

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* 17. Who is your current or most recent employer?

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* 18. How did you hear about the Volunteer Lawyers Program?

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* 19. In what area of law are you seeking help? (Select the one that best describes your current issue)

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