Application For Appointment To The Board Of Review Page 5
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12Institution
Course / Lecture / Forum
Brief Description of Your Participation
18. Have you held any appointive or elective public office, or have you been a candidate for elective
office? If so, please provide details.
Position
Dates
Brief Description
VII.
Employment History (Non-legal)
19. Have you ever been engaged in any occupation other than the practice of law (including any
occupation while practicing)? If so, please provide details, including dates and the name, current
address and telephone number of a person, preferably your supervisor, who can verify your
employment for each position listed below. Begin with most recent employment.
Company Name:
May we contact this employer?
Yes
No
Street Address:
Telephone:
Specific Duties:
City and State:
Zip Code:
Job Title:
Total Number of Employees Supervised by you:
Supervisor:
Dates Employed:
Hours Worked Per Week:
Salary:
Reason for Leaving:
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Parent category: Legal