UNITED STATES DISTRICT COURT FOR THE DISTRICT OF NEW MEXICO APPLICATION FOR MEMBERSHIP CRIMINAL JUSTICE ACT PANEL TO: CJA Panel Committee United States District Court 333 Lomas Blvd NW Albuquerque, NM 87102 Social Security No. Applicant Name _______________________________ _______________________________ Address & Zip (Business) Business Phone _________________________________ _________________________________ Address & Zip (Residence) Residence Phone 1. Email address __________________________________ 2. Location for which you are available (check appropriate locations) Albuquerque 3. Santa Fe Roswell Las Cruces You must be a member in good standing of the State Bar of New Mexico and the Bar of the United States District Court for the District of New Mexico. Date admitted to practice before the New Mexico Supreme Court: NM State Bar number: _____________________ Date admitted to practice before the U.S. District Court for NM : 4. Law Degree (school and year) Undergraduate or other degree(s) (degree, school and year) 1 American LegalNet, Inc. www.FormsWorkFlow.com 5. How long have you actively practiced law? 6. List other courts to which you have been admitted: Name of Court Location Date Admitted 7. a. Have you ever been disciplined by the Bar of any state or by any court? Yes No If yes, please explain. b. Have you ever been found to have provided ineffective assistance of counsel? Yes No If yes, please explain. c. Have you ever been found to be in contempt of court? Yes No If yes, please explain. 8. Would you be available for calls during non-office hours should there be an immediate need for an attorney to advise a defendant in custody? Yes No 2 American LegalNet, Inc. www.FormsWorkFlow.com 9. Are you willing to accept appointment on a contingency basis in cases not compensable under the Criminal Justice Act (for example: civil rights, Title VII EEO Matters)? Yes No 10. Panels for which you are applying: General Felony Panel Complex Case Panel Capital Panel Auxiliary Panel (aka "B Panel") Appeals/Habeas Corpus Panel 11. a. General Felony Panel members must have five years' criminal practice experience in state or federal court or three years experience as an Assistant US Attorney or Assistant Federal Public Defender. Please describe briefly your criminal practice experience. b. General Felony Panel members must have ten felony trials at least three of which are federal felony trials or significant federal non-trial experience or significant state court trial experience. How many felony trials have you had? How many of these trial were as lead defense counsel? How many of these trials were federal felony trials? How many federal felony criminal cases have you handled? i. ii. iii. iv. If you have not had ten felony trials, three of which were federal felony trials, please describe briefly any significant federal non-trial experience or significant state trial experience 3 American LegalNet, Inc. www.FormsWorkFlow.com c. General Felony Panel members must have experience with or knowledge of each of the following. Please indicate briefly your level of experience with or knowledge of : The Federal Rules of Criminal Procedure: very experienced experienced somewhat experienced vaguely familiar not experienced The Federal Rules of Evidence: very experienced experienced somewhat experienced vaguely familiar experienced The Federal Sentencing Guidelines: very experienced experienced somewhat experienced vaguely familiar experienced i. ii. not not iii. iv. The Local Criminal Rules of the U.S. District Court for the District of New Mexico: very experienced experienced somewhat experienced vaguely familiar not experienced v. The New Mexico Code of Professional Responsibility and "A Lawyer's Creed of Professionalism": very experienced experienced somewhat experienced vaguely familiar not experienced. 11. Complex Case Panel members will be appointed in complex or multi defendant criminal cases such as RICO or CCE cases or when the case is unusual or complex due to the number of defendants, the nature of the prosecution or the existence of novel questions of fact or law. Please describe briefly any special experience you have in complex or multi defendant cases. 4 American LegalNet, Inc. www.FormsWorkFlow.com 12. Capital Panel members will be appointed to represent defendants in cases in which the government may seek the death penalty under federal law or in post conviction proceedings challenging a sentence of death pursuant to 28 U.S.C. � 2254 or 2255. Capital panel members will undergo a separate screening process. Please indicate briefly your capital experience and whether you would be interested in first or second chair appointments or appellate or post conviction appointments. 13. Auxiliary Panel members will be those whose experience level does not meet the qualifications for the General Felony Panel. Those attorneys will be appointed to represent individuals charged with misdemeanor or petty offense cases or held as material witnesses. Please indicate briefly your experience with these types of cases. 14. Appeals/Habeas Corpus Panel. Would you be willing to accept appointments in appeals of federal criminal cases in the U.S. Court of Appeals for the 10 th Circuit? Ordinarily, appointments in the district court continue on appeal. The Court of Appeals may allow trial counsel to withdraw and may appoint separate appellate counsel after trial counsel has perfected the appeal. Trial counsel must perfect an appeal if requested by the client to do so. Please describe briefly your appellate and/or habeas corpus experience in federal or state court. If you would prefer appointments only in appeals or habeas corpus cases, please indicate that as well. 5 American LegalNet, Inc. www.FormsWorkFlow.com 15. Please describe briefly any additional, relevant criminal law experience, work experience, life experience, or experience with indigent populations, which you believe the selection committee ought to consider. 16. Are there any cases or types of cases you would not accept? Please explain. 17. Language knowledge in addition to English: Language Read Write Speak 9 9 9 9 9 9 9 9 9 6 American LegalNet, Inc. www.FormsWorkFlow.com 18. Have you ever been employed as a prosecutor, public defender, law clerk to a judge or justice, or as a judge or justice? Yes No Please describe this employment: 19. Please list names, addresses, and telephone numbers of at least three references who can attest to