SUPERIOR COURT OF CALIFORNIA, COUNTY OF FRESNO Application and Agreement for Family Law Indigent Panel California Rule of Court, Rule 5.242(c) states that before being appointed as counsel for a child in a family law proceeding, counsel must have completed at least 12 hours of applicable education and training which must include all of the following subjects: statutes, rules of court, and case law relating to child custody and visitation litigation; Representation of a child in custody and visitation proceedings; Special issues in representing a child, including the following: A) Various stages of child development B) Communication with a child at various developmental stages and presenting the child's view C) Recognizing, evaluating and understanding evidence of child abuse and neglect, family violence and substance abuse, cultural and ethnic diversity, and gender-specific issues D) The effects of domestic violence and child abuse and neglect on children and E) How to work effectively with multidisciplinary experts. Last Name Office Address Mailing Address Law School Date Admitted to Bar Other Bar Memberships First City City Initial Zip Zip Date Graduated Firm Name Phone No. Phone No. State Bar Number Date Began Practice Memberships on Other Panels (CCAP Central California Appellate Project - ) MUST ATTACH A COPY OF CURRENT STATE BAR MEMBERSHIP CARD What percentage of your current practice is devoted to the following areas of law? Criminal % Family % Parental Termination % Family Support How many years of practice have you had in the following areas of law? Parental Termination Criminal Family Family Support Are you interested in representing litigants in contempt proceedings, termination proceedings, or both? How many termination trials have you conducted in the past five years? Of those set out above, how many were Family Code section 7822 terminations? How many were Family Code section 8604 terminations? Are you interested in representing members of the military in Family Support matters? Describe your knowledge and experience with the Service Members Civil Relief Act and its protections. % PFL-35 E01-15 MANDATORY Application and Agreement for Family Law Indigent Panel Page 1 of 2 American LegalNet, Inc. www.FormsWorkFlow.com Have you been the subject of a disciplinary proceeding by the State Bar of California or by the Bar of any other State? Yes No If yes, attach a detailed description of the nature, date, case number and result of the disciplinary proceeding. Have you been sanctioned by this court or any other court in the past five years? Yes No If yes, attach a detailed description of the nature and date of the sanctions and the case number. By signing below, you agree to waive confidentiality for the sole purpose of enabling the State Bar of California to notify the Superior Court of California, County of Fresno, of the status of any disciplinary proceeding against you. State any areas of specific expertise and interest, and any limitations on the types of cases you want: REFERENCES: List names, addresses and telephone numbers of three persons familiar with your work. Please attach a resume setting forth your relevant experience and anything else you would like us to know about you. Please provide a short statement explaining why you are interested in joining the Family Law Indigent Panel. I hereby certify that all of the above information is true. I understand that by submitting this application I agree to cooperate with the Superior Court of California, County of Fresno on any cases assigned to me. I understand that this application will allow inquiry into my professional reputation by the Superior Court of California, County of Fresno. SIGN: DATE: COURT USE ONLY ACCEPTED PFL-35 E01-15 MANDATORY NOT ACCEPTED Fresno Superior Court Judicial Officer Application and Agreement for Family Law Indigent Panel Page 2 of 2 American LegalNet, Inc. www.FormsWorkFlow.com