Full Name(Required)Year Admitted to the Bar(Required)Firm/Employer Name(Required)Email(Required) Enter Email Confirm Email Office Physical Address(Required) Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Phone(Required)Counties in which you will accept referrals:(Required)I am in fluent in and willing to assist clients who speak the following languages:I will accept 2 civil cases through the VLP in the area(s) of law indicated below:(Required) Bankruptcy - Chapter 7 Collection/Repossession/Garnishment Contract & Warranty Issues Tort Defense Divorce (Contested/Uncontested) Divorce Involving Spouse Abuse Uncontested Custody/Visitation Contested Custody Contested Visitation Child Support Modification Adoptions/Legitimations Tax Name Change/Emancipation Homeownership/Real Property Issues Deeds Mortgage Foreclosures Housing/Landlord/Tenant Will Preparation Power of Attorney Estate Administration Guardianships/Conservatorships Non-Profit Assistance - Applying/Maintaining 501(c)(3) status Non-Profit Assistance - Contract Assistance Social Security - Cessation/Overpayments Virtual Clinic Expungement Clinic Wills for Heroes Clinic Privacy StatementAll information collected in this form will be used exclusively for the purpose of providing for indigent families in need of civil legal assistance. This information may be provided to a party outside the Alabama State Bar, but its use will be restricted exclusively to the purpose stated above. This information will not be sold or used for any marketing purposes by the ASB or any party to whom it is provided.
