Application For Special Master Form
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1
2Application for Special Master
(Please print or type)
FULL NAME: ___________________________________________________________
BUSINESS ADDRESS: ___________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
MAILING ADDRESS: ____________________________________________________
(if different) ____________________________________________________________
_____________________________________________________________
HOME TELEPHONE: _____________________
OFFICE TELEPHONE: ____________________ FAX #: ______________________
SOCIAL SECURITY #: __________________________________________________
FORMAL EDUCATION
SCHOOL
GRADUAT
ION DATE
DEGREE
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
DATE ENTERED LAW PRACTICE: ________________________________________
STATE BAR NUMBER: __________________________________________________
COUNTY OF ADMISSION: ______________________________________________
HAVE YOU HAD AT LEAST 3 YEARS OF LAW PRACTICE? __________________
WHAT TYPE(S) OF LAW DO YOU/ HAVE YOU PRACTICE(D)?
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
SPECIALTY (Circle One):
PROPERTY
BUSINESS
GENERAL
OTHER____________
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Parent category: Legal