U.S. District Court District of Massachusetts CJA Panel Application The following Application is to be completed by attorneys requesting appointment to the CJA list of individuals eligible to represent indigent defendants under the provisions of the Criminal Justice Act. Attention of the applicant is called to the Criminal Justice Act of 1964, as amended. 18 U.S.C. §3006A. Please note the instructions on the Court’s website for downloading and completing this Application, including that the answers must be typewritten. I am applying for: Boston; Worcester Habeas Panel (also complete supplemental application) 1. Full Name: Office Address: Office Phone: Office Email: Office Fax: Cell Phone: Home Address: Home Phone: -1American LegalNet, Inc. www.FormsWorkFlow.com Bar Admissions 2. Year of admission to the Massachusetts bar: Board of Bar Overseers number: Year of admission to U.S. District Court (Mass.): Year of admission to any other federal or state courts: Education 3. Please list all colleges and professional schools attended (other than law schools), and date of degree. RESPONSE: 4. Please list all law schools attended, and date of degree. RESPONSE: 5. Please describe any significant activities, honors or awards at the above schools. RESPONSE: 6. Have you served as a judicial law clerk or staff attorney to a court? RESPONSE: 7. Do you speak any foreign languages? Please identify them and your level of fluency. RESPONSE: -2American LegalNet, Inc. www.FormsWorkFlow.com Employment History 8. Please describe chronologically your employment or law practice since becoming a member of any state bar, including a description of your current practice. RESPONSE: Litigation Experience 9. Please describe any training or experience you have had with the Federal Rules of Criminal Procedure, Federal Rules of Evidence, Bail Reform Act of 1984, and the Federal Sentencing Guidelines. RESPONSE: 10. Approximately what percentage of your practice in the last 5 years has been devoted to litigation? % a. Approximately what percentage of such litigation practice in the last 5 years was: i. Criminal Civil Other ii. Practice in: Federal State Other b. _____ % _____ % _____ % = 100 % _____ % _____ % _____ % = 100 % Please indicate the approximate number of trials (bench or jury) you conducted in the past 5 years: ______ None 1 to 5 ______ 6 to 10 ______ 11 to 20 ______ 21 or more -3American LegalNet, Inc. www.FormsWorkFlow.com i. What percent of these trials were: ______ Jury ______ Non-jury = 100% c. Please indicate the approximate number of appeals handled over the past ten years: Federal State 11. Please state the approximate number of criminal cases in your career in which you were lead defense counsel in a jury trial. RESPONSE: a. b. How many in Superior Court? c. 12. How many in Federal Court? How many in District Court? Please state the approximate number of criminal cases in your career in which you were lead defense counsel and performed significant work, but which did not go to trial. RESPONSE: a. b. 13. How many in Federal Court? How many in Superior Court? Please state the approximate number of criminal cases in your career in which you were the lead prosecutor. RESPONSE: a. How many in Federal Court? b. How many of these cases included a jury trial? c. How many jury trials as a prosecutor in Superior Court? -4American LegalNet, Inc. www.FormsWorkFlow.com Specific Case Experience 14. Please identify your three most recent jury trials in Federal Court, including the docket number, judge and counsel involved, and nature of the case. Please include current phone numbers of the lawyers. RESPONSE: 15. If you have not had three jury trials in Federal Court, please identify your three most recent jury trials in Superior Court (or lacking those, then District Court), including the docket number, judge and counsel involved, and nature of the case. Please include current phone numbers of the lawyers. RESPONSE: 16. Please identify your three most recent criminal cases in Federal Court in which you were lead counsel and performed significant work, but which did not go to trial, including the docket number, judge and counsel involved, and nature of the case. Please include current phone numbers of the lawyers. RESPONSE: 17. If you have not had three such criminal cases in Federal Court, please identify your three most recent criminal cases in Superior Court in which you were lead counsel and performed significant work, but which did not go to trial, including the docket number, judge and counsel involved, and nature of the case. Please include current phone numbers of the lawyers. RESPONSE: -5American LegalNet, Inc. www.FormsWorkFlow.com Court-Appointment Experience 18. Have you previously applied for appointment to the CJA panel, and not been selected? If so, when? RESPONSE: 19. Are you familiar with the mandates that a CJA attorney must be willing to accept a variety of criminal cases, have computer-aided legal research, participate in PACER and electronic motion filing, represent the defendant on an appeal, schedule periodic Duty Day assignments, and attend continuing legal education programs as described in the Court’s CJA Plan? RESPONSE: 20. Have you ever been a member of the CJA panel? Please provide the years of membership. RESPONSE: 21. Approximately how many CJA appointments have you received in your entire career, and how many over the past three years? RESPONSE: 22. Have you been a member of a bar advocate group, murder list, or other panel to which court appointments are made in criminal cases? Please provide the years of membership, and the approximate number of cases to which you were appointed. RESPONSE: 23. The Court is committed to assuring that the CJA Panel’s membership is sensitive to the diversity of the defendant population it serves. What background, experience and perspectives would you bring to the Panel that would contribute to high quality legal representation for the diverse indigent population in Massachusetts? RESPONSE: -6American LegalNet, Inc. www.FormsWorkFlow.com 24. Please briefly state the reasons that you have applied for membership on the CJA Panel, and include any other information which you think would be helpful to the Board in evaluating your application. RESPONSE: Interest in Participating in a Mentor Program 25. If selected for membership on the CJA Panel, would you be interested in acting as a mentor for a less experienced attorney who is interested in future membership on the CJA Panel and who could benefit from observing your handling of this type of case? RESPONSE: 26. If not selected at this time for membership on the CJA Panel, would you be interested in assisting a CJA Panel member in handling a specific case assignment, without compensation, in order to gain more experience? RESPONSE: Professional 27. Please describe your participation as a faculty member at continuing legal education programs, bar association conferences, or law school forums over the past five years. RESPONSE: 28. Please describe your attendance at continuing legal education programs, bar association conferences, or law school forums over the past five years. RESPONSE: -7American LegalNet, Inc. www.FormsWorkFlow.com 29. Please identify your membership in bar associations or law-related organizations in the past ten years, and any leadership positions that you have held. RESPONSE: Conduct 30. Have you ever been disbarred, suspended, reprimanded, censured, or otherwise disciplined, publicly or privately, as an attorney, or as a member of any other profession, or as a holder of any public office? Are any charges or complaints now pending? If so, please provide the details. RESPONSE: References 31. Please list the names and phone numbers of no more than four persons (who are not judges) whom the CJA Board can contact to discuss your professional competence and qualifications for the CJA Panel. RESPONSE: 32. Please list the names of any Federal Judges or Magistrate Judges before whom you have practiced. RESPONSE: -8American LegalNet, Inc. www.FormsWorkFlow.com Writing Sample 33. Please attach (as a tabbed Appendix 1) one example of a brief, memorandum of law, or similar example of legal writing not to exceed fifteen pages - which was prepared solely by you within the past five years. If you do not have a sample of this length, please include an excerpt from a longer document. Do not exceed the fifteen-page limit. The Board’s preference is for a document which relates to a federal criminal case. I hereby certify that the above information is true and correct. Date: Applicant’s Signature An original and eleven (11) copies of the completed application(s) should be submitted by October 12, 2009 to: Helen Costello, Operations Manager United States District Court - Suite 2300 John Joseph Moakley United States Courthouse 1 Courthouse Way Boston, MA 02210 -9American LegalNet, Inc. www.FormsWorkFlow.com