FEDERAL COUNSEL1/CO-COUNSEL2 PROGRAM ATTORNEY'S EXPRESSION OF INTEREST IN PRO SE CIVIL CASES NAME: First Middle Last BUSINESS ADDRESS: Street TELEPHONE: ( ( ) City State ) FAX: ( Zip Code ) Office E-mail address: Cell Please list the best place and time to contact you: I have practiced law more than five (5) years. I have practiced law less than five (5) years. Do you have malpractice insurance? Yes No Date of admission before U.S. District Court of Colorado: I have experience/interest in the following areas: I speak the following foreign language(s): Date: Signature of Applicant Information Regarding Court Appointments: 1 2 Counsel indicates an attorney who has practiced more than five (5) years. Co-Counsel indicates an attorney who has practiced law less than five (5) years. 07/03 American LegalNet, Inc. www.FormsWorkFlow.com Your Expression of Interest will be kept on file awaiting direction from the Court to locate counsel. At such time, on an equitable basis among all applicants, you will be contacted and asked to accept the civil case of a pro se litigant. Please feel free to request an opportunity to review the file and/or contact the client prior to accepting the case. Upon your acceptance of the case, the Court will provide you with a copy of the file. The Court will also inform your client of your acceptance of the case. The Court asks that you promptly call the client to arrange a meeting. You will also receive information from the Faculty of Federal Advocates regarding assistance they provide to counsel and co-counsel in pro se civil cases. Please enter your appearance within ten (10) days of your acceptance of the case. Please note there are no Court funds available to pay for discovery, witnesses, in-house copying, or other fees. The filing and services fees may be waived, but there is no statutory authority to pay for any other expenses. The FFA may have funds available to help cover out-of-pocket expenses. Further information will be made available to you upon your acceptance of this case. The Court expresses, in advance, its appreciation for your willingness to provide this public service. Please Return Completed Form to: Mentor Program Coordinator, Clerk’s Office Alfred A. Arraj U.S. Courthouse 901 19th Street, Room A240 Denver, Colorado 80294-3589 Phone (303) 335-2139 Fax (303) 335-2375 07/03 American LegalNet, Inc. www.FormsWorkFlow.com