ATTORNEY REGISTRATION - BREVARD COUNTY
18th Judicial Circuit Pro Bono Plan
Administrative Agency: Brevard County Legal Aid, Inc. (BCLA)
1017 S. Florida Ave., Rockledge, Florida 32955  

 
Name: _____________________________________________
 
Phone: (321) ____________________
 
Firm Name: _________________________________________
 
Fax: (321) ______________________
 
Office Address: _____________________________________
 
E-Mail: ________________________
 
PO Box: _____________________ Fl. Bar #: _______________
 
City: ________________________ Zip _________
 
Years Practicing in Florida: _______
 
Foreign Languages Spoken: _______________________________________________
 

If you do not have liability insurance, BCLA provides $1,000,000 of malpractice insurance on pro bono cases referred by BCLA. If you do have coverage, the BCLA malpractice insurance will be secondary to your own coverage.
 
 
PLEASE CIRCLE YOUR PREFERENCE LISTED BELOW

1. CASE REPRESENTATION

YES, I will accept referrals in the following areas of law:

Family Law
      Assistance from BCLA staff or other volunteer attorneys is available.

If you would like an experienced attorney mentor to work with you,
   please check :    Yes    or    No

Civil Legal Services for the terminally ill or those with,
or affected by life threatening medical conditions.

Guardianships – Proposed ward is income eligible
– Proposed petitioner with limited income and assets

 Wills / Administration of Estates

Consumer Law
      Bankruptcy
      Repossession / Collection / Garnishment
      Contracts / Warranties / Insurance
      Unfair Sales Practices  

Housing Issues
      Mortgage Foreclosure
      Landlord Tenant
 
Adopt an Agency (Legal work for non-profits serving the poor)

Income Tax Attorneys (Assist lower income persons with tax credit or problems)

Assist Florida Institutional Legal Services with civil representation
of prison inmates in Brevard County.

Education / Expulsion Hearings

2. OTHER PRO BONO SERVICES

I am unable to accept case referrals at this time, but I will:

Staff an advice clinic for low income clients at the
      Brevard County Legal Aid, Inc. office in Rockledge.

Serve as a Family Law Mentor.
      I have over five years experience as a Florida Family Law Attorney.

Family Law Pro Se Assistance Program
      Participants can select from the following:
            Conduct workshops;
            Staff clinics;
            Contribute to a pro se manual; or join the
            Pro Se Task Force.
Government Attorneys
            Work on a special pro bono project through my employer.

3. FINANCIAL CONTRIBUTION

In lieu of pro bono service,
enclosed is my tax deductible contribution of $350.00.

In addition to pro bono service,
enclosed is a tax-deductible contribution of $ ____________________________