Request for Evaluation for Judicial Office

Request or Evaluation for Judicial Office

Name

First

Last

I. JUDICIAL POSITION SOUGHT:

II. BACKGROUND BIOGRAPHICAL INFORMATION

Current Title

Firm/Office

Duration

Address

City

State/Province

Zip/Postal

Phone

Bar Number

Date of Admission

Are you admitted to practice law in another state? If so, please state your bar number, the state where admitted, and the date of your admission.

Additional Bar Information:

Professional Associations/Distinctions/Awards or Articles/Publications, if any:

Notes:

File Upload

Maximum file size: 5MB

Link

If you use social media, (e.g. Facebook, Instagram, LinkedIn) please list both your personal and professional social media account usernames / handles:

Social Media

Have you ever been investigated or disciplined by the California Bar or any other state bar association?

Yes

If yes, please provide explanation, including date(s) of the discipline and describe the reason for the imposition of discipline/outcome:

Yes:

Have you been convicted of a crime (felony or misdemeanor) within the last ten years? If yes, please provide an explanation, including the charges, date of conviction(s), disposition, and date of dismissal if the conviction(s) has been dismissed/expunged pursuant to PC1203.4.

Yes:

III. EDUCATIONAL BACKGROUND

IV. COMMUNITY SERVICE/CURRENT MEMBERSHIP/LEADERSHIP/PROGRAMMING:

VI. EXPLAIN WHY YOU ARE SEEKING WLALA’S JUDICIAL ENDORSEMENT. (Max 500 words)

VII. THE FOLLOWING IS WLALA’S MISSION STATEMENT

VIII. CONFIDENTIALITY

IX. HOLD HARMLESS AND WAIVER AGREEMENT

ATTACHMENT(S)

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