Questionnaire And Application For Membership Page 6
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79.
Describe briefly the nature of your present practice:
10.
Are you fluent in any foreign languages?
Yes
No
Which ones?
11.
It is likely that most appointment will be made to CJA lawyers who will rotate “duty” weeks in magistrates’
court. Would you, as one of the duty attorney’s for a given week, be able to be in court within two hours
of notification by the appointing judge’s chambers?
Yes
No
12.
In which of the following categories of cases will you accept appointment (check boxes):
A.
0 - 12 trial days
B.
13 or more trial days
13.
Are you willing to handle “cold record” appeals (appeals from trials in which you were not trial counsel)?
Yes
No
14.
Are you willing to handle habeas corpus cases?
Yes
No
It is your responsibility to notify the Federal Public Defender, in writing, if any of the above
information changes.
I HEREBY CERTIFY that the aforesaid information is true and correct and that I have carefully read the
provisions of 18 U.S.C. §3006A(d) and (e). I request that I be considered for appointment to the panel for
representation of defendants under the Plan approved in accordance with the Criminal Justice Act of 1964, as
amended by the CJA Revision of 1986.
Date:
Signature:
CHECK BOX OF DIVISION PANEL YOU WANT TO SERVE:
FT MYERS
JACKSONVILLE
OCALA
ORLANDO
TAMPA
MAIL APPLICATION ONLY TO THE DIVISION IN WHICH YOU WISH TO BE A MEMBER
Application for Membership in Criminal Justice Act
Middle District of Florida
Revised: September 17, 2015
Page 6 of 7
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