SUPERIOR COURT OF CALIFORNIA COUNTY OF SANTA CLARA INITIAL APPLICATION FOR APPOINTMENT AS COUNSEL FOR MINOR CHILDREN IN FAMILY COURT CASES Name Business Address Year Admitted to CA Bar 1. Phone Number E-mail CA State Bar Number California Rule of Court 5.242 requires certain minimum qualifications before the Court can appoint a lawyer to represent a child in family law proceedings. Please attach to this application a Judicial Council form FL-322 completed except for question #2 and signed. If you have been appointed as counsel for a minor in a family law proceeding, please state the total number of such appointments: How many such appointments are currently pending? Please specify any languages other than English you speak well enough to communicate effectively with minor(s) and parents. 2. 3. 4. Do you have other particular skills, training, interests, or preferences (e.g., age, gender, family ethnicity, educational or medical issues)? 5. With respect to the twelve hours of education and training referenced in question #5 on FL-322, state the number of hours of study completed in each of the following areas: A. Statutes, rules of court and case law related to child custody and visitation litigation. Hours completed Year(s) in which study completed B. Representation of a child in custody and visitation proceedings. Hours completed Year(s) in which study completed C. Special issues in representing a child, including: 1. Various stages of child development; Hours completed Year(s) in which study completed FM-1081 REV 7/01/09 Page 1 of 2 American LegalNet, Inc. www.FormsWorkFlow.com INITIAL APPLICATION FOR APPOINTMENT AS COUNSEL FOR MINOR CHILDREN IN FAMILY COURT CASES (cont'd) 2. Communicating with a child at various developmental stages and presenting the child's view; Hours completed Year(s) in which study completed 3. Recognizing, evaluating and understanding evidence of child abuse and neglect, family violence and substance abuse, cultural and ethnic diversity, and gender specific issues; Hours completed Year(s) in which study completed 4. The effects of domestic violence and child abuse and neglect on children; Hours completed Year(s) in which study completed 5. How to work effectively with multidisciplinary experts. Hours completed Year(s) in which study completed I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct. Date: Signature FM-1081 REV 7/01/09 Page 2 of 2 American LegalNet, Inc. www.FormsWorkFlow.com