APPLICATION TO SERVE AS SETTLEMENT CONFERENCE ATTORNEY (Early Settlement Conference Program) ________________________________________________________________ SUPERIOR COURT OF CALIFORNIA COUNTY OF Yolo County Superior Court Please return completed Application to: ADR Administrator 725 Court Street Room 103 Woodland, CA 95695 1. Contact Information Name: Business Address: City: State: Zip: Mailing Address (if different): E-Mail: Telephones: Daytime: Evening: Cell (optional): FAX: 2. Areas of Interest I am willing to serve as a court-appointed volunteer settlement conference attorney in most civil cases (excluding Family Law cases) as follows: Business/Contracts PI Auto Construction PI Other Employment Public Agency Medical/Legal Real Estate I am available to serve at the following times: Mornings Afternoons Mondays (afternoon only) Days Assignments on short notice Other (describe): Wednesdays Thursdays I am not available to serve as follows (describe and explain): 3. Professional and Personal Qualifications Date of admission, State Bar of California: Application/ESCP Attorney June 2007 . State Bar No. 1 American LegalNet, Inc. www.FormsWorkflow.com Name: State Bar No. 3. Qualifications (continued) Other states of admission, date and bar number (a) Are you in good standing in each state where you are licensed to practice? Yes No (If no, provide an explanation in an attachment.) (b) I am certified as a specialist by the State Bar of California Board of Legal Specialization or by an organization whose specialization program has been accredited by the State Bar of California. Areas of specialization: (c) Have you ever been disciplined by the State Bar of California or by a bar association of other professional licensing entity in any state or by a court of record, including being Yes No held in contempt? (d) Do you have any disciplinary action pending against you by the State Bar of California or by a bar association or other professional licensing agency in any state or court of record, including any proceeding for the imposition of sanctions or for contempt? Yes No (If you answered “yes” to questions 3. (c) or (d), provide additional information in an Attachment.) 4. Experience and Training The principal portion of my law practice in California is in the following courts (specify state and federal courts, including trial and appellate courts, if applicable): I currently practice in the following areas of the law (list each subject area that occupies 10 percent or more of your time): Do you hold yourself out publicly as representing exclusively one side in any area of litigation practice? Yes No Application/ESCP Attorney June 2007 2 American LegalNet, Inc. www.FormsWorkflow.com Name: State Bar No. 4. Experience (continued) (If yes, provide the following information): Area of Practice Side Represented Have you ever served as a temporary judge? Yes No If yes, note the courts and locations where you have served, the dates of service, and types of matters heard (e.g., small claims, settlements, traffic, etc.): Describe any practice or other experience that you believe will assist you in serving as a settlement conference attorney. Describe any formal training that you believe will assist you in serving as a settlement conference attorney. 5. Contact Persons It may be necessary to contact you regarding matters in which you have been involved as a settlement conference attorney. Please list one individuals who will always know your whereabouts. Name: Business address: Business telephone Application/ESCP Attorney June 2007 Email address: 3 American LegalNet, Inc. www.FormsWorkflow.com Name: State Bar No. AGREEMENT (1) I understand and agree that my selection and appointment as Early Settlement Conference Program (ESCP) attorney is solely at the discretion of the court for the purpose of assisting the public and does not constitute an employment relationship. (2) I agree to preside as a volunteer ESCP attorney in at least three (3) scheduled conferences per year. (3) I agree to attend the ESCP settlement conference attorney training program scheduled for October 19, 2007. (Approximately 6 hours, MCLE accredited.) (4) I will comply with all provisions of the court’s ESCP policies as they may from time to time be announced by the court. Date: ______________________________ TYPE OR PRINT NAME OF APPLLICANT Application/ESCP Attorney June 2007 SIGNATURE OF APPLICANT 4 American LegalNet, Inc. www.FormsWorkflow.com