Attach
TWO
Recent
1" x 1-1/2"
Photos
APPLICATION FOR CERTIFICATION - SENIOR LAW STUDENT
ILLINOIS SUPREME COURT RULE 711
To: Administrative Office of the Illinois Courts
222 North LaSalle Street, 13 Floor
th
Chicago, Illinois 60601
THIS CERTIFIES THAT (please print or type):
First Name Middle Initial Last Name Social Security Number
Street Address City/State/Zip Code
( )
E-Mail Address Telephone Number
a law student at ________________________ School of Law has received credit for work representing at least one-half of
the total hourly credits required for graduation from the law school, is a student in good academic standing, and is eligible
under the school’s criteria to undertake the activities authorized by Illinois Supreme Court Rule 711. The above named
student is expected to graduate on _____________________.
Date
____________________________________
Dean of Law School Signature
Certified by the above named school this _________ day of ______________ , ___________ . (SCHOOL SEAL)
The services authorized by Illinois Supreme Court Rule 711, which I acknowledge I have read, will be performed for
me by:
Student’s Name
Full Name of Agency
Agency Address City/State/Zip Code
Agency Telephone Number Supervising Attorney’s Name and ARDC Number
(Must be a member in good standing of the Illinois bar)
The Agency indicated above is (check appropriate box):
A legal aid bureau, legal assistance program, organization or clinic chartered by the State of Illinois
or approved by a law school approved by the American Bar Association
The Office of the Public Defender
A law office of the State or any of its subdivisions
__________________________________________ Dated this ________ day of ___________________ , ________
Supervising Attorney's Signature
/
I have previously applied for a Rule 711 license:
Yes
No
I certify the information provided is accurate and true.
Student Certification (Signature)/Date
Rev. 4/20
For office use only: Approved by : ______________ Date: ______________ Expiration date: ______________
