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421 Madison Street.
Detroit, MI 48226
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Please check one:
New Applicant
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Applicant Information
FIRST NAME:
MIDDLE NAME:
LAST NAME:
BUS. ADDRESS:
CITY:
STATE:
ZIP CODE:
BUSINESS PHONE:
FAX:
CELL PHONE(XXX-XXX-XXXX):
E–mail*
DATE OF ADMISSION INTO THE STATE BAR OF MICHIGAN:
BAR NUMBER:
NATURE OF YOUR PRACTICE
DISTRICT COURT %:
TRAFFIC/CRIMINAL %:
CIVIL %:
CIRCUIT COURT %:
CRIMINAL %:
CIVIL %:
ARE YOU FLUENT IN A SECOND LANGUAGE?
YES
NO
IF YES, LIST LANGUAGE:
DO YOU HAVE FEWER THAN TWO (2) YEARS OF EXPERIENCE PRACTICING CRIMINAL DEFENSE IN MICHIGAN?
YES
NO
ARE YOU CERTIFIED IN AMERICAN SIGN LANGUAGE?
YES
NO
New Applicant - If not CAP certified, do you have (18) Hours of Continuing Legal Education Credits?
YES
NO
IF YOU HAVE FEWER THAN TWO (2) YEARS, HAVE YOU COMPLETED ONE BASIC SKILLS ACQUISITION CLASS?
YES
NO
ARE YOU WAYNE COUNTY CRIMINAL ADVOCACY PROGRAM (CAP) CERTIFIED?
YES
NO
Renewing Applicant - If not CAP certified, do you have (12) Hours of Continuing Legal Education Credits?
YES
NO
HAVE YOU EVER HAD A REQUEST FOR INVESTIGATION FILED AGAINST YOU WITH THE STATE ATTORNEY GRIEVANCE COMMISSION AND/OR HAVE YOU EVER BEEN DISCIPLINED BY THE ATTORNEY DISCIPLINE BOARD IN MICHIGAN OR ANY OTHER STATE? IF YES, PLEASE PROVIDE A DETAILED STATEMENT OF FACTS INCLUDING FINAL RESOLUTION WITH YOUR APPLICATION.
YES
NO
PREVIOUS POSITIONS WITHIN THE JUSTICE SYSTEM
LIST ANY POSITIONS HELD WITHIN THE JUSTICE SYSTEM. LIST CITY, COUNTY OR FEDERAL ENTITY AND YEAR(S).
DEFENSE ATTORNEY
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YEAR:
LADA
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YEAR:
MISD. DEFENDERS
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YEAR:
COUNTY APA
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CITY ATTORNEY
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ATTORNEY GENERAL
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JUDICIAL CLERKSHIP
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OTHER
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If you have any questions, please contact 36th District Court's Trial Services Department at (313) 965-2790.
I HEREBY CERTIFY THAT THE INFORMATION IN THIS APPLICATION IS TRUE AND COMPLETE. I UNDERSTAND THAT FALSE INFORMATION WILL RESULT IN MY REMOVAL OR INELIGIBILITY TO RECEIVE ASSIGNMENTS.
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