Application For Volunteer Civil Settlement Attorney Page 3

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JUDICIAL EXPERIENCE:
8.
Have your ever held judicial office (including as a commissioner, referee, administrative law
judge, or hearing officer) or been a candidate for judicial office? If so, please state the court or
agency involved and the dates of service, or dates of candidacy.
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
9.
Please describe any prior service as a temporary or pro tem judge (indicate court, case type
and approximate hearing dates):
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
10.
Have you ever acted as a mediator? ____ (years) As an arbitrator? ____ (years)
11.
Please describe any prior service as an arbitrator, mediator or settlement conference attorney:
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
SUPPLEMENTAL INFORMATION:
12.
Provide any pertinent information reflecting positively or adversely on you that you believe
should be disclosed to the Court and the selection panel in connection with your possible
nomination as a Volunteer Civil Settlement Attorney:
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
VOLUNTEER CIVIL SETTLEMENT ATTORNEY
APPLICANT’S INITIALS _________
-3-

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