PRO BONO APPLICATION TO: Pro Bono Appointments 901 Richland Street Columbia, SC 29201 803-765-5960 Federal Court Pro Bono Program FAX: RE: I wish to submit my name for inclusion on the list of attorneys who might be asked to volunteer to represent pro se plaintiffs in federal court litigation. It is my understanding that placing my name on the list does not automatically commit me to accept the appointment, as the presiding judge would consult with me before making an appointment. It is also my understanding that I may withdraw my name from the list at any time. Finally, it is my understanding that to receive pro bono credit with the South Carolina Bar and be covered by the Bar's malpractice policy for pro bono activities, I must complete the steps indicated in the section South Carolina Bar Pro Bono Service Credit. I am available to accept appointments in the following divisions: G Aiken G Anderson G Beaufort G Charleston G Columbia G Florence G Greenville G Spartanburg Other comments: _______________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ Name: ______________________________________________________________________________ Firm: _______________________________________________________________________________ Federal Court ID Number: ________________________SC Bar Number: ________________________ Address: ____________________________________________________________________________ Phone: ______________________________________________________________________________ E-mail: _____________________________________________________________________________ Date: ___________________ Signature: _________________________________________________ American LegalNet, Inc. www.FormsWorkFlow.com 82016