**Asterisks highlighted in red are required fields**

-=+=-- DO NOT USE AN APOSTROPHE IN ANY OF YOUR ANSWERS -=+=-

 

Personal Information
**First Name:
Middle Initial:
**Last Name:
**Address (Line 1) Firm Name:
 
**Address (Line 2):
 
**City:
**State:
**Zip
-
Code:

Contact Information
**Phone:(9512225555)
Fax:
Email Address:(johndoe@aol.com)
Website: (www.riverside.courts.ca.gov)

Bar Information
**BAR Number:
Date Admitted: (MM-DD-YYYY)
Current Bar Memberships (limit to 100 words):

Education & Background
**Education Background:
**Prior Practice: (List previous employers, describe type of practice, list relevant non legal employment)

**Subject Matter Expertise: (At least one subject matter required)
Personal Injury:
Employment:
Business:
Real Estate:
Malpractice:
(Legal,Medical,Dental)
Construction:
Insurance:
Product Liability:
Accounting:
Other:
  

Representation
In current Personal Injury litigation practice, % is on behalf of plaintiffs and
% is on behalf of defendants.
 
ADR Experience: Arbitration; Mediation; Settlement Conferences:
Describe your arbitration approach:
Briefs and other requirements: