UNITED STATES DISTRICT COURT CENTRAL DISTRICT OF CALIFORNIA CASE NUMBER: PLAINTIFF(S), v. STUDENT APPLICATION TO APPEAR UNDER THE STUDENT PRACTICE RULE (LOCAL CIVIL RULE 83-4) DEFENDANT(S). I, (Name of Student) , hereby apply to the Court for permission to appear under the supervision of (Name of Supervising Attorney) on behalf of (Name of Client) in the above entitled case. I declare under penalty of perjury that I am eligible to participate under the Student Practice Rule of the United States District Court, Central District Of California. Attached are all documents supporting my eligibility as required by this Rule. I understand that I am bound by the provisions of the Student Practice Rule and that the Judge may deny permission for me to appear at any time. Date Student's Signature NOTE: Form G-101 Order on Student Application to Appear, MUST be submitted with this Application. G-101 (03/09) STUDENT APPLICATION TO APPEAR UNDER THE STUDENT PRACTICE RULE (LOCAL CIVIL RULE 83-4) Page 1 of 2 American LegalNet, Inc. www.FormsWorkflow.com REQUEST AND DECLARATION TO UNDERTAKE SUPERVISION I, (Name of Supervising Attorney) (Name of Student) , hereby request permission to supervise (Name of Client) to appear on behalf of in the above entitled case. I declare under penalty of perjury that I understand my responsibilities as supervising attorney and I will immediately inform the Court of any changes in the student's eligibility. Date Supervising Attorney's Signature CLIENT CONSENT I hereby consent to (Name of Student) to appear on my behalf in the above entitled case. Date Client's Signature CERTIFICATE OF THE DEAN OF THE LAW SCHOOL I, (Name of Dean of Law School) , Dean of (Law School) , is currently enrolled in and hereby certify to the Court that (Name of Student) is in good standing with the law school, has completed one-half of the legal studies required for graduation and has completed the course work required to participate under the Student Practice Rule of the United States District Court, Central District of California. I further certify that I know of no reason that would render this student ineligible under the Student Practice Rule. I understand that this certification will remain in effect until the student graduates or until withdrawn. In the event this certification is withdrawn by me, I will immediately notify the Court, the student and the supervising attorney in writing stating the reasons of the withdrawal. Date Signature of Dean of Law School Title G-101 (03/09) STUDENT APPLICATION TO APPEAR UNDER THE STUDENT PRACTICE RULE (LOCAL CIVIL RULE 83-4) Page 2 of 2 American LegalNet, Inc. www.FormsWorkflow.com