ATTORNEY OR PARTY WITHOUT AN ATTORNEY (Name, State Bar number, and address): TELEPHONE NO: FAX NO. (Optional) EMAIL ADDRESS (Optional): ATTORNEY FOR (Name): FOR COURT USE ONLY SUPERIOR COURT OF CALIFORNIA COUNTY OF SANTA CRUZ 1 Second Street, Room 300 Watsonville, CA 95076 Watsonville Branch PLAINTIFF/PETITIONER : vs. DEFENDANT/RESPONDENT : DECLARATION OF ELIGIBILITY FOR REPRESENTATION IN DEPENDENCY COURT CASE NUMBER: Form Adopted for MANDATORY USE Superior Court of Santa Cruz County SUP JV 800 07/01/18 DECLARATION OF ELIGIBILITY FOR REPRESENTATION IN DEPENDENCY COURT Page 1 of 1 Welfare & Institutions Code 247317.5 California Rule of Court 5.660, Local Rules 6.2.06 & 6.2.07 SUP JV 800 CASE NUMBER: I (name): at (office address): , (phone number): and (email address) am an attorney at law licensed to practice in the State of California. My State Bar number is: . I hereby certify that I meet the minimum standards for practice before a Juvenile Dependency Court set forth in California Rule of Court 5.660 and Santa Cruz Local Rules 6.2.06 and 6.2.07, and that I have completed the minimum requirements for training, education and/or experience as set forth below. 1. Initial Eligibility for Appointment a. I declare that I am eligible for appointment to represent youth in dependency proceedings because I have completed a minimum of 12 hours of training or education in the areas of juvenile dependency as stated in Local Rule 6.2.06. Attach copies of MCLE certificates or other documentation of attendance. Retained Counsel without the minimum education must complete the required education within 60 days of their first court appearance. OR b. I declare that I have sufficient recent experience competently representing youth in dependency proceedings as described in the attachment. Attachment should include information about trial work including; case number, county in which case was heard, date of last appearance in the case, and party represented. 2. Continuing Eligibility I declare that in the last three years beginning (date initial Declaration of Eligibility for Representation was filed) through now, I have completed at least 8 hours of continuing education in juvenile dependency law each year. Attach copies of MCLE certificates or other documentation of attendance. 3. Number of pages attached . 4. Include my contact information on a public referral list maintained by the Court. I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct. Date: Signature American LegalNet, Inc. www.FormsWorkFlow.com