American LegalNet, Inc.www.USCourtForms.com 11. Birthplace: City StateTO THE COMMITTEE ONCHARACTER AND FITNESS OF THEBOARD OF COMMISSIONERSOF THEALABAMA STATE BARAPPLICATION FOR ADMISSION(Revised November 2004)MUST BE TYPEWRITTEN 9. Driver220s License: State CITY AND STATE: ZIPIF YOU ARE AT THE PRESENT TIME A LAW STUDENT AND HAVE NOT FILED THE STUDENT REGISTRATION APPLICATION, YOU MUST INCLUDE SUCH APPLICATION WITH THIS FILING. 1. Law school attended/attending City/State Date of Graduation 2. If a student, state anticipated date of graduation 3. Did you 223 le a Student Registration Application? Yes or No Month and year 223 led 4. Are you currently a permanent resident of Alabama? Yes or No 5. (a) Have you 223 led an application, preliminary or otherwise, leading to a bar examination in a jurisdiction other than Alabama? Yes or No State(s) (b) Are you planning to 223 le in another jurisdiction ( ) or to take an exam in another jurisdiction ( ) prior to taking the Alabama bar exam? Yes or No State(s) (c) Have you taken a recent bar examination and are now awaiting the results? Yes or No State(s) 6. Have you been admitted to the bar of any jurisdiction? Yes or No State(s)IF YOU HAVE ANSWERED 215YES216 TO 5 or 6, YOU MUST FILE THE NATIONAL CONFERENCE OF BAR EXAMINERS220 (NCBE) APPLICATION. NCBE applications may be obtained from the Admissions Of223 ce of the Alabama State Bar and MUST BE FILED WITH THIS APPLICATION (Rule II, B(2)). 7. Social Security Number 8.YOUR FULL NAME (NO INITIALS): PRESENT MAILING ADDRESS: STREET and/or POST OFFICE: TELEPHONE: ATTACH PASSPORT PHOTOTAKEN WITHIN LAST 6 MONTHS 11/2 to 1 5/8 22162216 ALABAMA STATE BARTelephone (334) 269-1515415 Dexter AvenueMail: Admissions, P.O. Box 671Montgomery, Alabama 36101www.admit@alabar.orgDo not write in this block(Include Area Codes) (Business) (Home) 10. Date of Birth: Month Day Year Age FormsWorkFlow American LegalNet, Inc.www.USCourtForms.com 12. Do you wish to typewrite the examination? Yes or No YOU MUST FURNISH YOUR OWN MANUAL/ELECTRIC TYPEWRITER. NO MEMORY OR OTHER ELECTRONIC EQUIPMENT MAY BE USED. 13. (a) Will you require special accommodations to take the Bar Examination? Yes or No (b) If yes, for purposes of determining appropriate accommodations, please give details and attach the documentation supporting your request. Request the 215Disability Questionnaire Form216 from the Admissions Of223 ce. 14. (a) STATE DATE YOU WISH TO BE EXAMINED: (Exams are given on the last Monday, Tuesday and Wednesday of each February and July: ESSAYS 204 Monday & Tuesday; MBE 204 Wednesday) (b) Have you taken the exam in Alabama previously? Month and year of last exam taken 15. (a) MARITAL STATUS: Single ( ) Married ( ) Separated ( ) Divorced ( ) Widowed ( ) (b) State the following of each marriage: DATE CITY & STATE FULL NAME OF SPOUSE (c) If presently married, state the following: SPOUSE220S EMPLOYER POSITION BUSINESS PHONE (d) If you have ever been divorced, state the following in each instance: DATE CITY & STATE FULL NAME OF SPOUSE GROUNDS FOR DIVORCEIF LEGALLY SEPARATED, ATTACH COPY OF SEPARATION PAPERS. IF DIVORCED, OR IF MARRIAGE WASANNULLED OR SET ASIDE, ATTACH COPIES OF THE COMPLAINT AND FINAL DECREE IN EACH IN-STANCE. (e) Was alimony or child support required of you? Yes or No (f) Are you in full compliance with such support payments? Yes or No If NO, give a full statement.(Deadlines for Requests: May 1 204 July Exam December 1 204 February Exam) YearYear2Yes or NoFebruaryJuly FormsWorkFlow American LegalNet, Inc.www.USCourtForms.com 16. Have you ever been known by any other name (including a nickname)? Yes or No If YES give name and state facts fully (if change was made by court order, attach a certi223 ed copy of such order). (If you are 223 ling under Rule II, B(2), go to Question 19) 17. List every permanent and temporary place of abode where you have resided more than one month since your 18th birthday or for the past ten years. CITY & STATE ZIP STREET ADDRESS MONTH & YEAR MONTH & YEAR FROMTO 18. State the following concerning your parents (if a parent is deceased please give name; if retired, please so state and give former employer and position; if owner of business, give name of business): Father220s Name FULL Address Home Phone Employer Position Business Phone Mother220s Name FULL Address Home Phone Employer Position Business Phone 19. (a) Are you a citizen of the United States? Yes or No (b) If foreign born, state the following: DATE OF IMMIGRATION/DATE AND PLACE OF NATURALIZATION/NATURALIZATION CERTIFICATE NO. (c) If you have not become naturalized, have you 223 led a DECLARATION OF INTENT to become a citizen of the United States of America? Attach a copy of the Declaration of Intent or any supporting documents. (d) If no, what is your current status?Yes or No3 FormsWorkFlow American LegalNet, Inc.www.USCourtForms.com 20. (a) Are you a citizen and legal resident of Alabama? Yes or No (b) If Yes, in what city and county do you claim legal residence? (c) How long have you been a citizen and legal resident of Alabama? 21. (a) City and State of your present voter registration? (b) If you are 223 ling as a non-resident, please state your reason for 223 ling for admission in Alabama: 22. Please indicate if you are planning to become a citizen and legal resident of Alabama: Yes or No 23. (a) Are you now or have you ever been a member of the armed forces of the United States, including the National Guard, Coast Guard or any of the reserve components? (b) If Yes, complete the following: (1) Branch of Service (2) Dates, Active Duty (3) Dates, Reserve Duty (4) Highest rank achieved (5) Service number (6) Date and type of discharge (7) If less than Honorable, explain fullyATTACH A COPY OF FORM DD/214 TO THIS APPLICATION (c) While in service were you ever charged with violating the Articles of War or any provision of the Uniform Code of Military Justice? (d) If Yes, please state the nature of the charge, the facts, disposition of the matter and the location and designation of the military establishment where such proceeding took place: 24. ATTENTION: MALE APPLICANTS Any male born after 1959 must be registered in compliance with the Military Selective Service Act (50 U.S.C. App. 451 et seq.). Refusal to register is a felony, punishable by imprisonment for not more than 223 ve years and a 223 ne of not more than $250,000, or both. Selective Service System, P.O. Box 94638, Palatine, IL 60094-4638 Selective Service Information number: 1-847-688-6888 Web site: www4.sss.govATTACH PHYSICAL EVIDENCE OF YOUR COMPLIANCE RECEIVED FROM SELECTIVE SERVICE Date City Yes or NoYes or No4 FormsWorkFlow American LegalNet, Inc.www.USCourtForms.com 25. List all colleges and universities (other than law school) that you have attended: 26. List all law schools you have attended or are now attending:THIS RULE APPLIES TO EVERYONE WHO DESIRES ADMISSION TO THE BAR OF ALABAMA. IF YOU HAVE COMPLETED LAW SCHOOL AND DID NOT FILE THE STUDENT REGISTRATION APPLICATION AS REQUIRED BY RULE I, A, YOU MUST SUBMIT A NOTARIZED AFFIDAVIT (no special form required) STATING REASONABLE CAUSE FOR NOT HAVING FILED SUCH APPLICA-TION AND ATTACH A CHECK MADE PAYABLE TO THE ALABAMA STATE BAR IN THE AMOUNT OF $100. THE AFFIDAVIT AND CHECK MUST BE ATTACHED TO THIS APPLICATION (RULE I,C).IF YOU HAVE GRADUATED LAW SCHOOL, ATTACH A CERTIFICATE OF GRADUATION FROM THE DEAN OF THE LAW SCHOOL. If you have not graduated law school you should request of the proper school of223 cials that such certi223 cation be mailed to this of223 ce IMMEDIATELY upon your graduation. You cannot be certi223 ed to sit for the Alabama State Bar Exam until such Certi223 cation of Graduation is received.The Certi223 cation of Graduation must be on school letter head, with the school seal af223 xed, and signed by the dean or certifying of223 cial. They MUST substantially be in the following form: 215DATE This is to certify that (applicant220s name) has pursued and satisfactorily completed as a full-time resident law student of (name of school) a course of law studies for a period of three years of at least 30 weeks each (or whatever the case may be, see Rule I