(04/2019)Page 1 of 8 en-USInstructions:en-US en-USAll applicants for admission to practice law in New York State must submit proof that they en-UShave satisfied the Skills Competency and Professional Values requirement set forth in section 520.18 of en-USthe Rules of the Court of Appeals (22 NYCRR 520.18). The applicant must complete this page and the en-USsection of this form that corresponds to the pathway under which the applicant seeks to satisfy section en-US520.18. For example, if seeking to satisfy section 520.18 under Pathway 1, only pages 1 and 2 of this form en-USmust be submitted. If seeking to satisfy section 520.18 under Pathway 4, only pages 1, 5, 6, and 7 must en-USbe submitted. The relevant pages of this form are to be filed as a necessary part of the application for en-USadmission. If any portion of this form is not in English, that portion must be accompanied by an English en-UStranslation that either is duly authenticated or includes a statement by the translator setting forth the en-UStranslator222s qualifications and certifying that the translation is accurate. For more information on the en-USSkills Competency and Professional Values admission requirement, including implementation dates, see en-USsection 520.18 and the Frequently Asked Questions applicable thereto, available at http://www.nycourts.en-USgov/ctapps/news/skills.pdf. Do not staple, or otherwise attach, this form to any other admission form. en-USPlease Print or Type This Form en-US Name of Applicant þ en-US en-US BOLE ID # þ en-US Street Address þ en-US City/Town/Village þ en-US en-US State þ en-US en-US ZIP þ en-US en-US Country (if not in US) þ en-US Telephone þ en-US en-US E-mail þ en-USAppellate Divisionen-US (check one) þ en-US en-US1st Dept. en-US en-US2nd Dept. en-US en-US3rd Dept. en-US en-US4th Dept. en-USI have satisfied the Skills Competency and Professional Values requirement by completing:en-US en-US(check one) en-US en-USPathway 1: Law school certification of competence in skills and professional values en-US en-USPathway 2: Law school certification of credit acquisition en-US en-USPathway 3: Pro Bono Scholars Program en-US en-USPathway 4: Apprenticeship en-US en-USPathway 5: Practice in another jurisdiction American LegalNet, Inc. www.FormsWorkFlow.com (04/2019)Page 2 of 8 en-USTo Be Completed if Applicant Satisfies Pathway 1: Law School Certification of Competence in Skills en-USand Professional Values en-USThe designated official from your law school must complete the following certification. The designated en-USofficial may then return this form directly to the Appellate Division designated by the applicant on page en-US1 or return the form to the applicant who can file it with and at the same time as the application for en-USadmission questionnaire. Do not staple, or otherwise attach, this form to any other admission form. þ en-USI en-US(name of law school official)en-US, en-US, am the en-US en-US(title)en-US en-US at en-US(name of law school)en-US 037 en-US, an American Bar Association-en-USapproved law school. I confirm: (a) that this law school has developed a plan identifying and en-USincorporating into its curriculum the skills and professional values that, in the school222s en-USjudgment, are required for its graduates222 basic competence and ethical participation in the legal en-USprofession, as required by ABA Standards and Rules of Procedure for the Approval of Law en-USSchools Standard 302(b), (c) and (d), and has made this plan publicly available on the law en-USschool222s website; and (b) that en-US(name of applicant) en-US en-UShas acquired sufficient competency in those skills and sufficient familiarity with those values. en-USOfficial Seal of Law Schoolen-USSignature of Official þ Title of Official þ Dated en-US(mm/dd/yyyy)en-US American LegalNet, Inc. www.FormsWorkFlow.com (04/2019)Page 3 of 8 en-USTo Be Completed if Applicant Satisfies Pathway 2: Acquisition of 15 Credits in Practice-Based en-USExperiential Coursework en-USThe designated official from your law school must complete the following certification. The designated en-USofficial may then return this form directly to the Appellate Division designated by the applicant on page en-US1 or return the form to the applicant who can file it with and at the same time as the application for en-USadmission questionnaire. Do not staple, or otherwise attach, this form to any other admission form. þ en-USI en-US(name of law school official)en-US, en-US, am the en-US en-US(title)en-US en-US at en-US(name of law school)en-US en-US, an American Bar Association-approved law en-USschool. I confirm that en-US(name of applicant) en-US en-US, successfully en-UScompleted at least 15 credit hours of practice-based experiential coursework, as defined by section en-US520.18(a)(2)(i) of the Rules of the Court of Appeals.* * þ Rule 520.18(a)(2)(iv) provides that a student may earn en-USup to six of the fifteen required creditsen-US through law school certified non-credit bearing en-USsummer employment supervised by an attorney in good standing in any state or territory of the United States or the District of Columbia. The en-USsupervising attorney must certify to the law school the beginning and ending dates of the employment, that the student satisfactorily completed en-USthe employment, and that the work experience: provided the student with an initial orientation session; implemented a system for assignments that en-USassured that the student was actually engaged in the performance of legal work, including a diversity of tasks, as part of the ongoing practical work en-USof the law office during normal business hours and throughout the required period; provided the student with experience and guidance in the skills en-USand values required for basic competence and ethical participation in the legal profession; gave the student timely oral and written feedback; and en-USengaged the student in reflection on the student222s experiences and learning during the employment. At least 50 hours of full-time employment is en-USrequired for each substituted credit under this subdivision. en-USOnly include summer work experiences that meet these requirements.en-USOfficial Seal of Law Schoolen-USSignature of Official þ Title of Official þ Dated en-US(mm/dd/yyyy)en-US American LegalNet, Inc. www.FormsWorkFlow.com (04/2019)Page 4 of 8 en-USTo Be Completed if Applicant Satisfies Pathway 3: Pro Bono Scholars Program en-USI en-US(en-USname of applicanten-US)en-US, en-US, successfully completed the en-USPro Bono Scholars Program as prescribed in section 520.17 of the Rules of the Court of Appeals. en-USProof of same is provided in the Form Affidavit of Applicant222s Completion of the Pro Bono Scholars en-USProgram, submitted herewith. en-USSignature of Applicant en-USDated en-US(mm/dd/yyyy)en-US en-US en-USIf this affidavit is sworn to outside the United States, its commonwealths, territories or possessions, en-USand the attesting officer is not a notary public, attach a certificate of the attesting officer222s authority to en-USattest to or witness the signature of the affiant in the jurisdiction. en-USSTATE 036COUNTRY035 OFen-US en-US035 þ COUNTY OF þ en-US)ss.: þ CITY OF þ en-US)en-USI en-US(en-USname of applicanten-US)en-US, en-US, SWEAR (OR AFFIRM) that en-USthe information contained in this Form Affidavit as to Compliance with the Skills Competency en-USand Professional Values Requirement is true and accurate to the best of my knowledge. en-USSignature of Applicant en-USDated en-US(mm/dd/yyyy)en-US en-US en-USSubscribed and sworn to or affirmed before me this en-US day of en-US in the year 20 en-US. en-USNotary Publicen-US(Sign & Affix seal or stamp) en-USIf the affidavit is not in English, it must be accompanied by an en-USEnglish translation that either is duly en-USauthenticated or includes a statement by the translator setting forth the translator222s qualifications and en-UScertifying that the translation is accurate. American LegalNet, Inc. www.FormsWorkFlow.com (04/2019)Page 5 of 8 en-USTo Be Completed if Applicant Satisfies Pathway 4: Apprenticeship en-USApplicants who complete an apprenti