**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: