Enrollment Form

Name/Bar Number:  ________________________________________________

Firm:  ___________________________________________________________

Address:  ________________________________________________________

Telephone:  ______________________________________________________

Email:  __________________________________________________________

Please indicate the areas of law that interest you/you are willing to consider referrals:

□  Family law (our greatest area of need)
    □  Guardian ad litem
    □  Protection from abuse cases

□  Bankruptcy
    □  Chapter 7
    □  Chapter 13 [attorney may petition the trustee   
        for additional fees up to $500]  

□  Debt collection defense
□  Other consumer law cases

□  Foreclosure defense
□  Evictions
□  Other real property cases

□  Education issues (special ed./discipline
    matters)

□  Wills/Estates

□  Guardianship cases

□  Unemployment compensation

□  Tax matters

□  Tort defense

□  Affirmative tort [in the rare situation where the client has been unable to retain an attorney without VLP assistance, the attorney may enter into a contingent fee agreement, not to exceed 25% of the recovery.]

□  SSDI and SSI denials, terminations and overpayments [Attorneys who accept cases for which a contingent fee is permitted (25% of retroactive benefits in denial cases) much also accept termination and overpayment cases.]    

□  I am interested in these other areas of law:

_________________________________________________________________

I will accept cases in the following geographic areas:
Counties: ________________________________________________________

Specific Courts: ___________________________________________________

□  I am interested in the limited representation of the Domestic Violence Pro Bono Panel (currently in the Augusta, Portland and West Bath courts)
□  I am interested in volunteering for the Family Law Helpline (Wednesday evenings in Portland from 5:30-8:00,  Friday afternoons 1:00 – 4:00
□  I am interested in the Pro Bono FED panel
□  I am interested in the Court House Assistance Forms Clinic (Augusta, Biddeford,
    Lewiston and Portland District Courthouses)
□  I am interested in the MASH (Maine Attorneys Saving Homes Project)
□  I am interested in helping to develop additional Projects             
□  I would like to accept cases through the direct referral program, rather than be called by the Lawyer of the Day.  I will take ___ cases per month/year (please circle).
□  I would like to be asked to accept cases through email, rather than be called by the Lawyer of the Day.
□  I wish to participate as Lawyer of the Day (currently requires coming to the Portland or Bangor office)
□  I am willing to mentor attorneys in the following areas:
     ______________________________________________________________

□  I am interested in working with a law student on my VLP case.
□  I am interested in talking with a VLP staff member to learn more about the pro bono opportunities available.

Comments: _______________________________________________________

Please Return this form to:
Maine Volunteers Lawyers Project
P.O. Box 547
Portland, Maine 04112
207-400-3221 phone
207-828-2300 fax
Thank you in advance for your time.